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ICD-10 Guide
ICD-10 CodesM61.419

M61.419

Billable

Other calcification of muscle, unspecified shoulder

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

Code Description

ICD-10 M61.419 is a billable code used to indicate a diagnosis of other calcification of muscle, unspecified shoulder.

Key Diagnostic Point:

M61.419 refers to the condition characterized by abnormal calcification in the muscle tissue of the shoulder region, which is not classified under more specific categories. This condition can arise from various underlying causes, including metabolic disorders, trauma, or chronic inflammation. Calcification in muscle can lead to stiffness, pain, and reduced range of motion, impacting the patient's quality of life and functional abilities. It may be associated with other muscle disorders such as myositis, where inflammation of the muscle tissue occurs, leading to muscle weakness and discomfort. The calcification process can be a result of dystrophic calcification, where calcium deposits form in damaged or necrotic tissue, or metastatic calcification, which occurs due to systemic conditions affecting calcium metabolism. Accurate diagnosis often requires imaging studies, such as X-rays or MRI, to visualize the extent and location of calcification. Treatment may involve physical therapy, pain management, and addressing any underlying conditions contributing to the calcification.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and underlying causes
  • Need for precise documentation of symptoms and imaging results
  • Differentiation from other muscle disorders and calcification types
  • Potential for co-existing conditions that complicate coding

Audit Risk Factors

  • Inadequate documentation of the clinical rationale for the diagnosis
  • Failure to specify the location of calcification
  • Lack of imaging studies to support the diagnosis
  • Misclassification with other muscle disorders

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, clinical notes on range of motion, and treatment plans.

Common Clinical Scenarios

Patients presenting with shoulder pain and limited mobility due to calcification.

Billing Considerations

Ensure that the documentation clearly states the relationship between calcification and any underlying conditions.

Rheumatology

Documentation Requirements

Comprehensive history of systemic conditions, lab results, and treatment responses.

Common Clinical Scenarios

Patients with autoimmune disorders presenting with calcification as a complication.

Billing Considerations

Document any systemic involvement that may contribute to muscle calcification.

Coding Guidelines

Inclusion Criteria

Use M61.419 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the calcification is not specified as due to trauma or other known conditions
  • Document the clinical findings and any imaging results that support the diagnosis

Exclusion Criteria

Do NOT use M61.419 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

73030CPT Code

Radiologic examination, shoulder

Clinical Scenario

Used when imaging is performed to assess calcification in the shoulder.

Documentation Requirements

Radiology report detailing findings of calcification.

Specialty Considerations

Orthopedic specialists should ensure imaging correlates with clinical findings.

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 nuances of this condition and its underlying causes, which 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 nuances of this condition and its underlying causes, which 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 nuances of this condition and its underlying causes, which 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, metabolic disorders, chronic inflammation, and certain systemic diseases. Each case may require specific diagnostic approaches to determine the underlying cause.