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ICD-10 Guide
ICD-10 CodesM61.461

M61.461

Billable

Other calcification of muscle, right lower leg

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

Code Description

ICD-10 M61.461 is a billable code used to indicate a diagnosis of other calcification of muscle, right lower leg.

Key Diagnostic Point:

M61.461 refers to the condition characterized by abnormal calcification in the muscle tissue of the right lower leg. This calcification can occur due to various underlying conditions, including myositis, trauma, or metabolic disorders. Patients may present with symptoms such as localized pain, muscle weakness, and reduced range of motion in the affected leg. The calcification can be detected through imaging studies, such as X-rays or MRI, which reveal the presence of calcium deposits within the muscle tissue. The etiology of muscle calcification can vary, with some cases being idiopathic while others are associated with systemic conditions like hyperparathyroidism or chronic kidney disease. Treatment typically focuses on addressing the underlying cause, managing symptoms, and may include physical therapy to improve muscle function and mobility. Accurate coding of this condition is essential for proper reimbursement and to ensure that the patient's medical history is accurately reflected in their health records.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in underlying causes of calcification
  • Need for precise documentation of symptoms and imaging results
  • Differentiation from other muscle disorders
  • Potential for co-existing conditions affecting muscle function

Audit Risk Factors

  • Inadequate documentation of the underlying cause of calcification
  • Failure to document associated symptoms or functional limitations
  • Misclassification of the site of calcification
  • Lack of imaging results to support the diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, clinical notes on muscle function, and treatment plans.

Common Clinical Scenarios

Patients presenting with pain and weakness in the right lower leg, often following trauma or surgery.

Billing Considerations

Ensure that the documentation clearly states the location and extent of calcification.

Rheumatology

Documentation Requirements

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

Common Clinical Scenarios

Patients with autoimmune disorders presenting with muscle pain and calcification.

Billing Considerations

Document any systemic involvement that may contribute to muscle calcification.

Coding Guidelines

Inclusion Criteria

Use M61.461 When
  • According to ICD
  • 10 coding guidelines, M61
  • 461 should be used when there is clear documentation of calcification in the muscle of the right lower leg
  • It is important to include any relevant imaging studies and clinical findings that support the diagnosis

Exclusion Criteria

Do NOT use M61.461 When
  • Exclusion criteria include conditions that are not specifically related to muscle calcification

Related ICD-10 Codes

Related CPT Codes

73030CPT Code

Radiologic examination, lower extremity, complete, including two views

Clinical Scenario

When imaging is performed to evaluate muscle calcification.

Documentation Requirements

Radiology report detailing findings and correlation with clinical symptoms.

Specialty Considerations

Orthopedic specialists should ensure imaging correlates with the diagnosis.

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 accuracy of patient records and reimbursement processes. M61.461 provides a clear distinction for muscle calcification localized to the right lower leg, which was less specific in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of muscle calcification, improving the accuracy of patient records and reimbursement processes. M61.461 provides a clear distinction for muscle calcification localized to the right lower leg, which was less specific in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. M61.461 provides a clear distinction for muscle calcification localized to the right lower leg, which was less specific in ICD-9.

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 metabolic disorders, trauma, inflammatory conditions like myositis, and certain systemic diseases.

How is muscle calcification diagnosed?

Diagnosis typically involves clinical evaluation, imaging studies such as X-rays or MRI, and laboratory tests to identify underlying conditions.

What treatments are available for muscle calcification?

Treatment focuses on addressing the underlying cause, managing symptoms, and may include physical therapy to improve muscle function.