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ICD-10 Guide
ICD-10 CodesM61.549

M61.549

Billable

Other ossification of muscle, unspecified hand

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

Code Description

ICD-10 M61.549 is a billable code used to indicate a diagnosis of other ossification of muscle, unspecified hand.

Key Diagnostic Point:

M61.549 refers to a condition characterized by abnormal ossification or calcification of muscle tissue in the hand, which is not classified under more specific categories. This condition can arise from various underlying factors, including trauma, chronic inflammation, or myositis, where muscle tissue becomes inflamed. The ossification process can lead to stiffness, pain, and reduced range of motion in the affected hand, impacting daily activities and overall quality of life. Patients may experience muscle weakness and functional impairment, which can complicate rehabilitation efforts. The diagnosis often requires imaging studies to confirm the presence of ossified tissue and to rule out other conditions such as tumors or infections. Treatment may involve physical therapy, pain management, and in some cases, surgical intervention to remove the ossified tissue. Accurate coding is essential for proper management and reimbursement, as it reflects the complexity of the patient's condition and the necessary interventions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for precise documentation of muscle involvement
  • Differentiation from other ossification disorders
  • Potential for co-existing neuromuscular conditions

Audit Risk Factors

  • Insufficient documentation of clinical findings
  • Lack of imaging reports to support diagnosis
  • Inconsistent terminology in medical records
  • Failure to document treatment plans and outcomes

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 stiffness in the hand following trauma or chronic inflammatory conditions.

Billing Considerations

Ensure that all relevant imaging studies are included in the documentation to support the diagnosis.

Rheumatology

Documentation Requirements

Comprehensive assessment of inflammatory markers and muscle function tests.

Common Clinical Scenarios

Patients with myositis or other inflammatory muscle disorders presenting with ossification.

Billing Considerations

Document any systemic symptoms or laboratory findings that may indicate an underlying rheumatologic condition.

Coding Guidelines

Inclusion Criteria

Use M61.549 When
  • According to ICD
  • 10 coding guidelines, M61
  • 549 should be used when there is clear documentation of ossification of muscle in the hand without a more specific diagnosis
  • Coders should ensure that the documentation supports the diagnosis and that all relevant clinical information is included

Exclusion Criteria

Do NOT use M61.549 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 a patient with muscle ossification also requires joint aspiration.

Documentation Requirements

Document the indication for the procedure and any findings during the aspiration.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is justified based on the patient's condition.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of muscle disorders, including ossification. M61.549 provides a means to capture cases that do not fit neatly into other categories, but it requires careful documentation to avoid ambiguity.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of muscle disorders, including ossification. M61.549 provides a means to capture cases that do not fit neatly into other categories, but it requires careful documentation to avoid ambiguity.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of muscle disorders, including ossification. M61.549 provides a means to capture cases that do not fit neatly into other categories, but it requires careful documentation to avoid ambiguity.

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 is the primary cause of ossification in muscle?

Ossification in muscle can be caused by trauma, chronic inflammation, or certain genetic conditions. It is essential to evaluate the patient's history and clinical findings to determine the underlying cause.