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ICD-10 Guide
ICD-10 CodesM61.139

M61.139

Billable

Myositis ossificans progressiva, unspecified forearm

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

Code Description

ICD-10 M61.139 is a billable code used to indicate a diagnosis of myositis ossificans progressiva, unspecified forearm.

Key Diagnostic Point:

Myositis ossificans progressiva (MOP) is a rare genetic disorder characterized by the abnormal formation of bone in muscles, tendons, and other connective tissues. This condition typically begins in early childhood and progresses over time, leading to significant muscle weakness and restricted mobility. In the case of unspecified forearm involvement, the ossification occurs in the muscles of the forearm, which can severely limit the range of motion and functionality of the arm. Patients may experience episodes of swelling, pain, and stiffness in the affected areas, often exacerbated by trauma or injury. The ossification process is gradual and can lead to the formation of heterotopic bone, which is bone that develops in an abnormal location. Diagnosis is primarily clinical, supported by imaging studies such as X-rays or MRI to visualize the ossified areas. Management focuses on symptomatic relief, physical therapy, and avoiding activities that may trigger further ossification. Due to the progressive nature of the disease, ongoing monitoring and supportive care are essential.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Rarity of the condition makes it less familiar to coders.
  • Potential for misdiagnosis with other muscle disorders.
  • Need for precise documentation of symptoms and progression.
  • Variability in clinical presentation among patients.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to specify the affected muscle group.
  • Misinterpretation of imaging results.
  • Lack of evidence for the diagnosis in the medical record.

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

Detailed clinical notes on muscle strength, range of motion, and imaging results.

Common Clinical Scenarios

Patients presenting with unexplained muscle pain and swelling, particularly after trauma.

Billing Considerations

Rheumatologists should be aware of the genetic basis of MOP and consider genetic counseling for affected families.

Orthopedics

Documentation Requirements

Surgical notes if intervention is performed, including pre-operative assessments.

Common Clinical Scenarios

Patients requiring surgical intervention for severe ossification affecting mobility.

Billing Considerations

Orthopedic surgeons must document the extent of ossification and its impact on function.

Coding Guidelines

Inclusion Criteria

Use M61.139 When
  • Follow the ICD
  • CM guidelines for coding myositis and ensure that the documentation supports the diagnosis
  • Include details on the specific muscle group affected and any relevant imaging findings

Exclusion Criteria

Do NOT use M61.139 When
  • Exclude codes for other types of myositis unless specified

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits for patients with myositis ossificans progressiva.

Documentation Requirements

Document history, examination findings, and treatment plan.

Specialty Considerations

Rheumatologists should ensure comprehensive documentation of symptoms and treatment response.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows for more specific coding of myositis ossificans progressiva, improving data accuracy and facilitating better patient management through detailed documentation.

ICD-9 vs ICD-10

The transition to ICD-10 allows for more specific coding of myositis ossificans progressiva, improving data accuracy and facilitating better patient management through detailed documentation.

Reimbursement & Billing Impact

The transition to ICD-10 allows for more specific coding of myositis ossificans progressiva, improving data accuracy and facilitating better patient management through detailed documentation.

Resources

Clinical References

  • •
    Myositis ossificans progressiva overview

Coding & Billing References

  • •
    Myositis ossificans progressiva overview

Frequently Asked Questions

What are the common symptoms of myositis ossificans progressiva?

Common symptoms include swelling, pain, stiffness in the affected muscles, and progressive loss of mobility. Symptoms often worsen after trauma.