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ICD-10 Guide
ICD-10 CodesM61.559

M61.559

Billable

Other ossification of muscle, unspecified thigh

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

Code Description

ICD-10 M61.559 is a billable code used to indicate a diagnosis of other ossification of muscle, unspecified thigh.

Key Diagnostic Point:

M61.559 refers to a condition characterized by abnormal ossification or calcification of muscle tissue in the thigh region, which is not classified under more specific ossification disorders. This condition can arise from various etiologies, including trauma, prolonged immobilization, or certain myopathies. The ossification process can lead to stiffness, pain, and reduced range of motion in the affected muscle, potentially impacting mobility and quality of life. Patients may present with muscle weakness or myositis, which can complicate the clinical picture. Diagnosis typically involves imaging studies such as X-rays or MRI to visualize the ossified areas and differentiate them from other muscle disorders. Treatment may include physical therapy, pain management, and in some cases, surgical intervention to remove the ossified tissue. Accurate coding is essential for proper reimbursement and to ensure that the patient's condition is adequately documented in their medical record.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for imaging studies to confirm diagnosis
  • Differentiation from other muscle disorders
  • Potential for co-existing conditions affecting coding

Audit Risk Factors

  • Insufficient documentation of clinical findings
  • Lack of imaging reports to support diagnosis
  • Inconsistent coding of co-existing conditions
  • Failure to specify the affected muscle group

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with pain and stiffness in the thigh after trauma or surgery.

Billing Considerations

Ensure clear documentation of the extent of ossification and its impact on function.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, therapy notes, and progress reports.

Common Clinical Scenarios

Rehabilitation of patients with muscle stiffness and weakness due to ossification.

Billing Considerations

Documenting the impact on mobility and rehabilitation goals is crucial.

Coding Guidelines

Inclusion Criteria

Use M61.559 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the code is used only when the condition is confirmed by clinical findings and imaging

Exclusion Criteria

Do NOT use M61.559 When
  • Exclude conditions that are more specifically defined under other codes

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

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

Clinical Scenario

Used when joint pain is present alongside muscle ossification.

Documentation Requirements

Document the reason for the procedure and any imaging findings.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is justified based on clinical findings.

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 patient records and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of muscle ossification disorders, improving the accuracy of patient records and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 of muscle?

Ossification of muscle can be caused by trauma, prolonged immobilization, or certain myopathies. It is essential to evaluate the patient's history and clinical presentation to determine the underlying cause.