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ICD-10 Guide
ICD-10 CodesM61.022

M61.022

Billable

Myositis ossificans traumatica, left upper arm

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

Code Description

ICD-10 M61.022 is a billable code used to indicate a diagnosis of myositis ossificans traumatica, left upper arm.

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 arises 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 M61.022, the condition specifically affects the left upper arm. Clinically, patients may present with localized pain, swelling, and reduced range of motion in the arm. Muscle weakness may also be observed due to the encroachment of bone formation on muscle fibers, which can impair normal muscle function. Diagnosis is often confirmed through imaging studies, such as X-rays or MRI, which reveal the presence of heterotopic ossification. Treatment may involve physical therapy, pain management, and in some cases, surgical intervention to remove the ossified tissue if it significantly impacts function. Understanding the nuances of myositis ossificans is crucial for effective management and coding, as it can significantly affect a patient's recovery and rehabilitation process.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of specific anatomical locations (left upper arm)
  • Differentiation from other types of myositis and ossification disorders
  • Need for precise documentation of trauma history
  • Potential for co-existing conditions affecting muscle function

Audit Risk Factors

  • Inadequate documentation of trauma history
  • Failure to specify laterality (left vs. right)
  • Misdiagnosis or coding of similar conditions
  • Lack of imaging documentation to support diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed injury history, imaging results, and treatment plans must be documented.

Common Clinical Scenarios

Post-traumatic cases following sports injuries or accidents.

Billing Considerations

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

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments and rehabilitation progress notes are essential.

Common Clinical Scenarios

Patients undergoing rehabilitation after trauma with muscle weakness.

Billing Considerations

Documenting the impact of myositis ossificans on rehabilitation outcomes is critical.

Coding Guidelines

Inclusion Criteria

Use M61.022 When
  • Follow the official ICD
  • CM coding guidelines for myositis ossificans, ensuring accurate laterality and specificity
  • Include documentation of the traumatic event and any imaging studies that support the diagnosis

Exclusion Criteria

Do NOT use M61.022 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 for pain management in patients with myositis ossificans.

Documentation Requirements

Document the joint involved and the reason for the procedure.

Specialty Considerations

Orthopedic specialists may perform this procedure for symptomatic relief.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding myositis ossificans, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding myositis ossificans, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding myositis ossificans, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of outcomes and resource allocation.

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 or connective tissue following trauma, leading to pain and functional impairment.