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ICD-10 Guide
ICD-10 CodesM61.4

M61.4

Billable

Other calcification of muscle

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

Code Description

ICD-10 M61.4 is a billable code used to indicate a diagnosis of other calcification of muscle.

Key Diagnostic Point:

M61.4 refers to the condition characterized by abnormal calcification in muscle tissue, which can occur due to various underlying causes such as trauma, inflammation, or metabolic disorders. This calcification can lead to muscle stiffness, pain, and weakness, impacting mobility and overall muscle function. Conditions like myositis, which is inflammation of the muscle, can predispose individuals to calcification as a result of chronic inflammation. Additionally, neuromuscular conditions may exacerbate muscle weakness and complicate the clinical picture. The calcification may be localized or diffuse and can be detected through imaging studies such as X-rays or MRI. Clinicians must evaluate the patient's history, physical examination findings, and any associated symptoms to determine the underlying cause of the calcification and to guide appropriate management. Treatment may involve addressing the underlying condition, physical therapy, and pain management strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying conditions that can lead to calcification
  • Need for detailed clinical documentation to support diagnosis
  • Potential overlap with other muscle disorders
  • Variability in presentation and symptoms among patients

Audit Risk Factors

  • Inadequate documentation of the underlying cause of calcification
  • Failure to include imaging results in the medical record
  • Misclassification of calcification as a primary diagnosis without supporting evidence
  • Lack of clarity in distinguishing between different types of muscle disorders

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

Detailed history of symptoms, physical examination findings, and imaging results.

Common Clinical Scenarios

Patients presenting with muscle pain and stiffness, particularly after trauma or in the context of autoimmune diseases.

Billing Considerations

Consideration of systemic conditions that may contribute to calcification, such as connective tissue diseases.

Neurology

Documentation Requirements

Neurological examination findings, history of neuromuscular symptoms, and any relevant diagnostic tests.

Common Clinical Scenarios

Patients with unexplained muscle weakness and neurological deficits.

Billing Considerations

Differentiating between primary muscle disorders and secondary conditions affecting muscle function.

Coding Guidelines

Inclusion Criteria

Use M61.4 When
  • According to ICD
  • 10 coding guidelines, M61
  • 4 should be used when calcification of muscle is documented without a more specific diagnosis
  • Coders should ensure that the documentation supports the diagnosis and that any underlying conditions are also coded appropriately

Exclusion Criteria

Do NOT use M61.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

73030CPT Code

Radiologic examination, shoulder, complete, including 2 views

Clinical Scenario

When imaging is performed to evaluate for calcification in muscle.

Documentation Requirements

Radiology report detailing findings of calcification.

Specialty Considerations

Ensure correlation between imaging findings and clinical symptoms.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of muscle calcification, improving the ability to capture the complexity of muscle disorders and their underlying causes. This specificity aids in better patient management and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of muscle calcification, improving the ability to capture the complexity of muscle disorders and their underlying causes. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of muscle calcification, improving the ability to capture the complexity of muscle disorders and their underlying causes. This specificity aids in better patient management and resource allocation.

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 are the common causes of muscle calcification?

Common causes include trauma, chronic inflammation, metabolic disorders, and certain autoimmune conditions. Each of these can lead to abnormal calcium deposition in muscle tissue.