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ICD-10 Guide
ICD-10 CodesM61.319

M61.319

Billable

Calcification and ossification of muscles associated with burns, unspecified shoulder

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M61.319 is a billable code used to indicate a diagnosis of calcification and ossification of muscles associated with burns, unspecified shoulder.

Key Diagnostic Point:

Calcification and ossification of muscles associated with burns is a condition that occurs when muscle tissue undergoes pathological changes due to thermal injury. This can lead to the deposition of calcium salts in the muscle tissue, resulting in stiffness, pain, and reduced mobility. The unspecified shoulder designation indicates that the specific shoulder affected is not documented, which can complicate treatment and rehabilitation efforts. Patients may experience muscle weakness and myositis, which is inflammation of the muscle tissue, further exacerbating their condition. The calcification process can be a response to the healing of the burn, but it can also lead to neuromuscular complications, affecting the patient's overall functional capacity. Proper diagnosis often requires imaging studies to assess the extent of calcification and to differentiate it from other muscle disorders. Treatment may involve physical therapy, pain management, and in some cases, surgical intervention to remove calcified tissue.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified location complicates treatment planning.
  • Requires understanding of burn-related muscle pathology.
  • Differentiation from other muscle disorders is necessary.
  • Potential for co-morbid conditions affecting coding.

Audit Risk Factors

  • Insufficient documentation linking burns to muscle calcification.
  • Lack of specificity regarding the affected shoulder.
  • Inadequate clinical rationale for the diagnosis.
  • Failure to document treatment plans and outcomes.

Specialty Focus

Medical Specialties

Physical Medicine and Rehabilitation

Documentation Requirements

Detailed assessment of muscle function and range of motion, treatment plans, and progress notes.

Common Clinical Scenarios

Patients recovering from burn injuries with muscle stiffness and weakness.

Billing Considerations

Documentation must reflect the impact of calcification on rehabilitation goals.

Orthopedic Surgery

Documentation Requirements

Surgical notes if intervention is performed, imaging studies, and post-operative care documentation.

Common Clinical Scenarios

Surgical removal of calcified muscle tissue in burn patients.

Billing Considerations

Clear documentation of the surgical necessity and outcomes is critical.

Coding Guidelines

Inclusion Criteria

Use M61.319 When
  • Follow ICD
  • CM coding guidelines for specificity and accuracy
  • Ensure that the documentation supports the diagnosis of calcification and ossification due to burns
  • The unspecified shoulder designation should be used only when the specific shoulder is not documented

Exclusion Criteria

Do NOT use M61.319 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

97110CPT Code

Therapeutic exercises

Clinical Scenario

Used in rehabilitation of patients with muscle calcification post-burn.

Documentation Requirements

Documentation of the patient's progress and specific exercises performed.

Specialty Considerations

Physical therapists should document the rationale for therapy based on muscle function.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding muscle conditions related to burns, improving the accuracy of patient records and treatment plans. M61.319 reflects the need for detailed documentation to support the unspecified nature of the condition.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding muscle conditions related to burns, improving the accuracy of patient records and treatment plans. M61.319 reflects the need for detailed documentation to support the unspecified nature of the condition.

Reimbursement & Billing Impact

reimbursement and to avoid claim denials.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of the unspecified shoulder in M61.319?

The unspecified shoulder indicates that the specific shoulder affected by calcification is not documented, which can complicate treatment and rehabilitation efforts. It is important for coders to ensure that documentation supports this designation to avoid ambiguity.