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ICD-10 Guide
ICD-10 CodesM61.472

M61.472

Billable

Other calcification of muscle, left ankle and foot

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

Code Description

ICD-10 M61.472 is a billable code used to indicate a diagnosis of other calcification of muscle, left ankle and foot.

Key Diagnostic Point:

M61.472 refers to the condition characterized by abnormal calcification of muscle tissue specifically located in the left ankle and foot. This condition can arise from various underlying causes, including trauma, chronic inflammation, or metabolic disorders. Calcification in muscle can lead to stiffness, pain, and reduced mobility, impacting the patient's quality of life. It may be associated with myositis, a condition where muscle inflammation occurs, leading to muscle weakness and discomfort. The calcification can be detected through imaging studies such as X-rays or MRI, which reveal the presence of calcium deposits in the muscle tissue. Clinicians must consider the patient's history, physical examination findings, and any relevant laboratory results to accurately diagnose and manage this condition. Treatment may involve physical therapy, pain management, and addressing any underlying causes to prevent further calcification.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of muscle pathology and calcification processes.
  • Differentiation from other muscle disorders such as myositis.
  • Need for precise documentation of location and extent of calcification.
  • Potential overlap with other ICD-10 codes related to muscle disorders.

Audit Risk Factors

  • Insufficient documentation of the underlying cause of calcification.
  • Failure to specify the exact location of calcification.
  • Inadequate linkage between diagnosis and treatment provided.
  • Misuse of related codes that may lead to incorrect billing.

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 in the left ankle and foot.

Billing Considerations

Consideration of autoimmune conditions that may contribute to calcification.

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 ankle and foot.

Billing Considerations

Documentation of functional limitations and impact on mobility.

Coding Guidelines

Inclusion Criteria

Use M61.472 When
  • According to ICD
  • 10 coding guidelines, M61
  • 472 should be used when there is clear documentation of calcification in the specified muscle group
  • It is important to ensure that the diagnosis is supported by imaging studies and that the condition is not a result of another underlying disorder

Exclusion Criteria

Do NOT use M61.472 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

73030CPT Code

Radiologic examination, ankle, two views

Clinical Scenario

Used to evaluate calcification in the left ankle.

Documentation Requirements

Radiology report confirming calcification.

Specialty Considerations

Orthopedic specialists may require additional imaging for surgical planning.

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 M61.472, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of muscle disorders and their management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M61.472, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of muscle disorders and their management.

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 are the common causes of muscle calcification?

Common causes include trauma, chronic inflammation, metabolic disorders, and certain autoimmune conditions. It is essential to evaluate the patient's history and symptoms to determine the underlying cause.