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ICD-10 Guide
ICD-10 CodesM61.029

M61.029

Billable

Myositis ossificans traumatica, unspecified upper arm

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

Code Description

ICD-10 M61.029 is a billable code used to indicate a diagnosis of myositis ossificans traumatica, unspecified 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 an injury, such as a fracture or severe contusion, leading to inflammation and subsequent ossification. In the case of the unspecified upper arm, the condition affects the muscles in that region, potentially leading to pain, swelling, and restricted movement. Patients may experience muscle weakness due to the infiltration of bone into the muscle tissue, which can impair normal muscle function. Diagnosis is often confirmed through imaging studies, such as X-rays or MRI, which reveal the presence of calcified areas within the muscle. Treatment usually involves physical therapy, pain management, and in some cases, surgical intervention to remove the ossified tissue if it significantly impacts function. Understanding the underlying muscle disorders and neuromuscular conditions is crucial for effective management and rehabilitation of affected patients.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of muscle pathology and trauma-related conditions.
  • Differentiation from other types of myositis and ossification disorders.
  • Need for precise documentation of the injury and its impact on muscle function.
  • Potential for co-morbid conditions affecting muscle strength and recovery.

Audit Risk Factors

  • Inadequate documentation of the traumatic event leading to myositis.
  • Failure to document the extent of muscle weakness or functional impairment.
  • Misclassification of the condition due to lack of specificity.
  • Inconsistent coding practices across different providers.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed injury history, imaging results, and treatment plans.

Common Clinical Scenarios

Post-traumatic evaluation of upper arm injuries, surgical interventions for ossification.

Billing Considerations

Ensure clarity in documentation regarding the mechanism of injury and subsequent treatment.

Physical Medicine and Rehabilitation

Documentation Requirements

Assessment of muscle strength, functional limitations, and rehabilitation goals.

Common Clinical Scenarios

Rehabilitation following trauma, management of muscle weakness due to myositis.

Billing Considerations

Focus on documenting functional outcomes and progress in therapy.

Coding Guidelines

Inclusion Criteria

Use M61.029 When
  • Follow official ICD
  • CM guidelines for coding myositis ossificans, ensuring accurate documentation of the traumatic event and its effects on muscle function
  • Include any relevant co
  • morbid conditions that may affect treatment

Exclusion Criteria

Do NOT use M61.029 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 joint aspiration is needed due to swelling from myositis.

Documentation Requirements

Document the reason for aspiration and findings.

Specialty Considerations

Orthopedic specialists often perform this procedure.

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, enabling better tracking of treatment outcomes and resource allocation. This code provides a clear framework for documenting trauma-related muscle conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding myositis ossificans, enabling better tracking of treatment outcomes and resource allocation. This code provides a clear framework for documenting trauma-related muscle conditions.

Reimbursement & Billing Impact

impact on muscle function. Ensure that all relevant clinical findings are included to support the diagnosis and treatment plan.

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 within muscle after an injury, leading to pain and functional impairment.

How is myositis ossificans diagnosed?

Diagnosis is typically made through clinical evaluation and imaging studies that reveal calcification in the affected muscle.

What are the treatment options for myositis ossificans?

Treatment may include physical therapy, pain management, and in some cases, surgical removal of the ossified tissue.