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ICD-10 Guide
ICD-10 CodesM61.062

M61.062

Billable

Myositis ossificans traumatica, left lower leg

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

Code Description

ICD-10 M61.062 is a billable code used to indicate a diagnosis of myositis ossificans traumatica, left lower leg.

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 the left lower leg, the muscle tissue may undergo calcification, resulting in pain, swelling, and restricted movement. Patients may experience muscle weakness due to the compromised integrity of the muscle fibers and surrounding tissues. Diagnosis is often confirmed through imaging studies, such as X-rays or MRI, which reveal the presence of calcified masses within the muscle. Treatment usually involves conservative management, including physical therapy, pain management, and in some cases, surgical intervention to remove the ossified tissue if it causes significant functional impairment. Understanding the underlying muscle disorders and neuromuscular conditions is crucial for effective management and rehabilitation of affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of specific muscle disorders and their implications.
  • Differentiation from other types of myositis and ossification disorders.
  • Need for precise documentation of trauma history.
  • Potential for co-existing conditions affecting coding.

Audit Risk Factors

  • Inadequate documentation of the traumatic event leading to myositis.
  • Failure to specify the location of ossification.
  • Misclassification of myositis type.
  • Lack of imaging reports to support diagnosis.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed history of trauma, imaging studies, and treatment plans.

Common Clinical Scenarios

Post-traumatic cases following fractures or severe muscle injuries.

Billing Considerations

Ensure accurate documentation of the extent of ossification and functional impairment.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, rehabilitation goals, and progress notes.

Common Clinical Scenarios

Patients undergoing rehabilitation post-injury with myositis ossificans.

Billing Considerations

Focus on documenting muscle strength assessments and therapy outcomes.

Coding Guidelines

Inclusion Criteria

Use M61.062 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the traumatic event and the specific location of ossification
  • Include any relevant co
  • existing conditions that may affect treatment and recovery

Exclusion Criteria

Do NOT use M61.062 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 involvement is suspected alongside myositis.

Documentation Requirements

Document the reason for aspiration and findings.

Specialty Considerations

Orthopedic specialists may frequently perform this procedure.

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 within muscle tissue following trauma, leading to pain and restricted movement.

How is myositis ossificans diagnosed?

Diagnosis typically involves a thorough history of trauma, clinical examination, and imaging studies such as X-rays or MRI to identify calcified areas within the muscle.

What are the treatment options for myositis ossificans?

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

Can myositis ossificans occur without trauma?

No, myositis ossificans traumatica specifically refers to ossification that occurs following a traumatic event.