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ICD-10 Guide
ICD-10 CodesM61.431

M61.431

Billable

Other calcification of muscle, right forearm

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

Code Description

ICD-10 M61.431 is a billable code used to indicate a diagnosis of other calcification of muscle, right forearm.

Key Diagnostic Point:

M61.431 refers to the condition characterized by abnormal calcification of muscle tissue in the right forearm. This condition can arise from various underlying factors, including metabolic disorders, trauma, or chronic inflammation. Calcification in muscle can lead to stiffness, pain, and reduced range of motion, impacting the patient's ability to perform daily activities. It may be associated with myositis, a condition where muscle inflammation occurs, leading to muscle weakness and discomfort. In some cases, calcification can be a result of dystrophic calcification, where calcium deposits form in damaged or necrotic tissue. Clinicians must evaluate the patient's history, physical examination findings, and imaging studies to determine the cause of the calcification and to rule out other neuromuscular conditions. Treatment may involve physical therapy, pain management, and addressing the underlying cause of the calcification. Accurate coding is essential for proper reimbursement and to reflect the patient's clinical status.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of muscle calcification
  • Understanding the underlying causes of calcification
  • Documenting associated symptoms and conditions
  • Navigating related codes for muscle disorders

Audit Risk Factors

  • Inadequate documentation of the location of calcification
  • Failure to document associated symptoms or conditions
  • Misclassification of the type of calcification
  • Lack of clarity in the underlying cause of the condition

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 hyperparathyroidism or renal failure.

Orthopedics

Documentation Requirements

Surgical notes, imaging studies, and post-operative follow-up documentation.

Common Clinical Scenarios

Patients with calcification following trauma or surgery in the forearm.

Billing Considerations

Documentation of any surgical interventions or physical therapy recommendations.

Coding Guidelines

Inclusion Criteria

Use M61.431 When
  • According to ICD
  • 10 coding guidelines, M61
  • 431 should be used when there is clear documentation of calcification in the right forearm muscle
  • Coders must ensure that the documentation supports the diagnosis and that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use M61.431 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

73030CPT Code

Radiologic examination, forearm

Clinical Scenario

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

Documentation Requirements

Radiology report must clearly indicate the findings related to muscle calcification.

Specialty Considerations

Ensure that the imaging is justified based on 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 conditions like M61.431, improving the accuracy of patient records and reimbursement processes. This specificity helps in better tracking of muscle disorders and their treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M61.431, improving the accuracy of patient records and reimbursement processes. This specificity helps in better tracking of muscle disorders and their treatment outcomes.

Reimbursement & Billing Impact

reimbursement processes. This specificity helps in better tracking of muscle disorders and their treatment outcomes.

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 systemic diseases. It is essential to evaluate the patient's history and conduct appropriate imaging to determine the underlying cause.