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ICD-10 Guide
ICD-10 CodesM61.14

M61.14

Billable

Myositis ossificans progressiva, hand and finger(s)

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

Code Description

ICD-10 M61.14 is a billable code used to indicate a diagnosis of myositis ossificans progressiva, hand and finger(s).

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 cases where the hand and fingers are affected, patients may experience stiffness, pain, and a gradual loss of function due to the ossification of soft tissues. The condition is caused by mutations in the ACVR1 gene, which plays a crucial role in bone growth and development. Diagnosis is often made through clinical evaluation, imaging studies, and genetic testing. Management focuses on symptomatic relief, physical therapy, and avoiding trauma to affected areas, as injuries can exacerbate ossification. Understanding the implications of MOP is essential for healthcare providers, as it impacts the patient's quality of life and requires a multidisciplinary approach for optimal care.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Rarity of the condition leading to limited familiarity among coders
  • Need for precise documentation of symptoms and progression
  • Potential for misdiagnosis with other myositis conditions
  • Requirement for genetic testing results to support diagnosis

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to include genetic testing results
  • Misinterpretation of symptoms leading to incorrect coding
  • Lack of multidisciplinary notes in patient records

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

Detailed clinical notes on muscle strength, range of motion, and any imaging studies performed.

Common Clinical Scenarios

Patients presenting with progressive muscle stiffness and pain in the hands and fingers.

Billing Considerations

Ensure that all relevant genetic testing and imaging results are included in the documentation.

Genetics

Documentation Requirements

Comprehensive family history and genetic test results to confirm diagnosis.

Common Clinical Scenarios

Patients with a family history of myositis ossificans or unexplained ossification.

Billing Considerations

Documentation should clearly outline the genetic basis of the condition and any counseling provided.

Coding Guidelines

Inclusion Criteria

Use M61.14 When
  • According to ICD
  • 10 guidelines, M61
  • 14 should be used when myositis ossificans progressiva is specifically diagnosed in the hand and fingers
  • Coders should ensure that the diagnosis is supported by clinical findings and any relevant imaging or genetic testing

Exclusion Criteria

Do NOT use M61.14 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

97001CPT Code

Physical therapy evaluation

Clinical Scenario

Used for initial assessment of muscle function and mobility in patients with MOP.

Documentation Requirements

Detailed evaluation notes including range of motion and strength testing.

Specialty Considerations

Physical therapists should document specific limitations due to ossification.

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 progressiva, improving the accuracy of patient records and facilitating better management of rare diseases.

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

impact of the condition on daily functioning are also essential.

Resources

Clinical References

  • •
    Myositis ossificans progressiva: A comprehensive overview

Coding & Billing References

  • •
    Myositis ossificans progressiva: A comprehensive overview

Frequently Asked Questions

What is myositis ossificans progressiva?

Myositis ossificans progressiva is a rare genetic disorder characterized by the abnormal formation of bone in muscles and connective tissues, leading to progressive disability.

How is M61.14 diagnosed?

Diagnosis is made through clinical evaluation, imaging studies, and genetic testing to confirm mutations in the ACVR1 gene.