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ICD-10 Guide
ICD-10 CodesM61.012

M61.012

Billable

Myositis ossificans traumatica, left shoulder

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

Code Description

ICD-10 M61.012 is a billable code used to indicate a diagnosis of myositis ossificans traumatica, left shoulder.

Key Diagnostic Point:

Myositis ossificans traumatica is a condition characterized by the abnormal formation of bone tissue within muscle or connective tissue following trauma. This condition typically occurs after a significant injury, such as a fracture or severe contusion, leading to inflammation and subsequent ossification in the affected area. In the case of the left shoulder, the muscle tissue surrounding the shoulder joint becomes inflamed due to trauma, and over time, this inflammation can lead to the formation of bone in the muscle. Patients may experience pain, swelling, and limited range of motion in the shoulder. Diagnosis is often confirmed through imaging studies such as X-rays or MRI, which can reveal the presence of calcified tissue. Treatment may involve physical therapy, pain management, and in some cases, surgical intervention to remove the ossified tissue if it severely limits function. Understanding the underlying muscle disorders and neuromuscular conditions is crucial, as myositis ossificans can lead to muscle weakness and functional impairment if not addressed appropriately.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of trauma-related conditions
  • Differentiation from other types of myositis
  • Need for precise documentation of the affected site
  • Potential for co-morbid conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of trauma history
  • Failure to specify the affected muscle group
  • Misinterpretation of imaging results
  • Inconsistent clinical findings in documentation

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the mechanism of injury, imaging results, and treatment plan.

Common Clinical Scenarios

Patients presenting with shoulder pain following a sports injury or fall.

Billing Considerations

Ensure that all imaging studies are documented and correlate with clinical findings.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessment of functional limitations and rehabilitation goals.

Common Clinical Scenarios

Patients requiring rehabilitation after surgical intervention for myositis ossificans.

Billing Considerations

Document progress notes meticulously to support ongoing therapy needs.

Coding Guidelines

Inclusion Criteria

Use M61.012 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the trauma and affected site
  • Include any relevant co
  • morbid conditions that may impact treatment

Exclusion Criteria

Do NOT use M61.012 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 injecting corticosteroids for pain management in myositis ossificans.

Documentation Requirements

Document the indication for injection and the specific joint involved.

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 conditions like myositis ossificans, improving the accuracy of patient records and facilitating better treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like myositis ossificans, improving the accuracy of patient records and facilitating better treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like myositis ossificans, improving the accuracy of patient records and facilitating better treatment planning.

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 myositis ossificans traumatica?

Myositis ossificans traumatica is a condition where bone tissue forms in muscle after trauma, leading to pain and restricted movement.

How is myositis ossificans diagnosed?

Diagnosis typically involves a clinical evaluation, imaging studies like X-rays or MRI, and a history of trauma.

What are the treatment options for myositis ossificans?

Treatment may include physical therapy, pain management, and possibly surgery to remove ossified tissue if it affects function.