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ICD-10 Guide
ICD-10 CodesM61.146

M61.146

Billable

Myositis ossificans progressiva, unspecified finger(s)

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

Code Description

ICD-10 M61.146 is a billable code used to indicate a diagnosis of myositis ossificans progressiva, unspecified 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 the case of unspecified finger(s), the ossification occurs in the muscles surrounding the fingers, which can lead to stiffness, pain, and functional impairment. Patients may experience episodes of swelling and inflammation in the affected areas, followed by the gradual development of bone tissue. The condition is often misdiagnosed due to its rarity and the overlap of symptoms with other neuromuscular disorders. Diagnosis is primarily clinical, supported by imaging studies that reveal heterotopic ossification. Genetic testing can confirm mutations in the ACVR1 gene, which are responsible for the condition. Management focuses on symptomatic relief, physical therapy, and avoiding trauma to the affected areas to prevent exacerbation of ossification. Understanding the complexities of MOP is crucial for accurate coding and appropriate patient management.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Rarity of the condition leading to potential misdiagnosis.
  • Need for comprehensive documentation to support the diagnosis.
  • Variability in clinical presentation among patients.
  • Potential for overlapping symptoms with other muscle disorders.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to include genetic testing results.
  • Misinterpretation of symptoms leading to incorrect coding.
  • Lack of clear differentiation from other myositis types.

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

Detailed clinical notes on muscle weakness, pain, and functional limitations.

Common Clinical Scenarios

Patients presenting with unexplained muscle stiffness and swelling.

Billing Considerations

Ensure genetic testing results are included in the medical record.

Genetics

Documentation Requirements

Genetic test results and family history of similar conditions.

Common Clinical Scenarios

Patients with a family history of myositis ossificans or related disorders.

Billing Considerations

Document the specific genetic mutations identified.

Coding Guidelines

Inclusion Criteria

Use M61.146 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant imaging or genetic testing results to substantiate the diagnosis

Exclusion Criteria

Do NOT use M61.146 When
  • Exclude codes for other types of myositis unless specifically documented

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits for management of myositis ossificans progressiva.

Documentation Requirements

Detailed notes on patient history, examination findings, and treatment plan.

Specialty Considerations

Rheumatology and genetics specialists should document the rationale for ongoing management.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of rare conditions like myositis ossificans progressiva, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of rare conditions like myositis ossificans progressiva, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    Myositis Association

Coding & Billing References

  • •
    Myositis Association

Frequently Asked Questions

What are the common symptoms of myositis ossificans progressiva?

Common symptoms include progressive muscle stiffness, pain, swelling in affected areas, and limited range of motion, particularly in the fingers and limbs.