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v1.0.0
ICD-10 Guide
ICD-10 CodesM61.529

M61.529

Billable

Other ossification of muscle, unspecified upper arm

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

Code Description

ICD-10 M61.529 is a billable code used to indicate a diagnosis of other ossification of muscle, unspecified upper arm.

Key Diagnostic Point:

M61.529 refers to a condition characterized by abnormal ossification or calcification of muscle tissue in the upper arm, which is not classified under more specific ossification disorders. This condition can arise from various underlying causes, including trauma, inflammation, or idiopathic factors. Patients may present with muscle stiffness, pain, and reduced range of motion in the affected arm. The ossification can lead to muscle weakness and functional impairment, impacting daily activities. Diagnosis typically involves imaging studies such as X-rays or MRI to visualize the ossified areas and differentiate them from other muscle disorders like myositis or neuromuscular conditions. Treatment may include physical therapy, pain management, and in some cases, surgical intervention to remove the ossified tissue. Understanding the etiology and clinical presentation is crucial for accurate coding and management of the condition.

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 findings
  • Differentiation from other muscle disorders like myositis
  • Potential for co-existing conditions that may complicate coding

Audit Risk Factors

  • Inadequate documentation of the clinical rationale for the diagnosis
  • Failure to document imaging studies that support the diagnosis
  • Misclassification of the condition due to lack of specificity
  • Inconsistent coding practices among different providers

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with pain and limited mobility in the upper arm due to ossification.

Billing Considerations

Ensure that all imaging studies are documented and correlate with the diagnosis.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessment of functional limitations and rehabilitation goals.

Common Clinical Scenarios

Patients requiring rehabilitation post-surgery for ossification removal.

Billing Considerations

Document progress and response to therapy to support ongoing treatment.

Coding Guidelines

Inclusion Criteria

Use M61.529 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant imaging studies and treatment plans in the patient's record

Exclusion Criteria

Do NOT use M61.529 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used when treating associated joint pain due to muscle ossification.

Documentation Requirements

Document the indication for the procedure and any imaging findings.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is linked to 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 ossification disorders, improving the accuracy of diagnoses and treatment plans. M61.529 provides a unique code for unspecified cases, which helps in tracking and managing these conditions more effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of muscle ossification disorders, improving the accuracy of diagnoses and treatment plans. M61.529 provides a unique code for unspecified cases, which helps in tracking and managing these conditions more effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of muscle ossification disorders, improving the accuracy of diagnoses and treatment plans. M61.529 provides a unique code for unspecified cases, which helps in tracking and managing these conditions more effectively.

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 symptoms associated with M61.529?

Common symptoms include pain, stiffness, and reduced range of motion in the upper arm, often accompanied by muscle weakness.

How is M61.529 diagnosed?

Diagnosis typically involves a clinical evaluation, imaging studies such as X-rays or MRI, and exclusion of other muscle disorders.

What treatment options are available for M61.529?

Treatment may include physical therapy, pain management, and surgical intervention if necessary to remove ossified tissue.