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ICD-10 Guide
ICD-10 CodesM61.175

M61.175

Billable

Myositis ossificans progressiva, left foot

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

Code Description

ICD-10 M61.175 is a billable code used to indicate a diagnosis of myositis ossificans progressiva, left foot.

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 is caused by mutations in the ACVR1 gene, which leads to dysregulation of bone morphogenetic proteins (BMPs) that promote bone formation. In patients with MOP, episodes of soft tissue swelling and inflammation are often followed by the development of heterotopic ossification, particularly in the muscles of the limbs. The left foot may be affected, leading to significant muscle weakness and restricted mobility. Patients may experience pain, stiffness, and decreased range of motion as the ossification progresses. Diagnosis is typically made through clinical evaluation, imaging studies such as X-rays or MRI, and genetic testing. Management focuses on symptomatic relief and physical therapy, as surgical intervention is often complicated by the risk of further ossification. Understanding the implications of this condition is crucial for effective treatment and rehabilitation.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Rarity of the condition makes it less familiar to coders.
  • Requires understanding of genetic implications and specific diagnostic criteria.
  • Potential for misdiagnosis with other muscle disorders.
  • Documentation must clearly specify the affected site and nature of the condition.

Audit Risk Factors

  • Insufficient documentation of genetic testing results.
  • Lack of clarity on the specific site of ossification.
  • Inadequate patient history regarding previous episodes.
  • Failure to document the impact on mobility and function.

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

Detailed clinical notes on symptoms, family history, and genetic testing 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 and potential for progressive symptoms.

Orthopedics

Documentation Requirements

Imaging studies and surgical notes if intervention is considered.

Common Clinical Scenarios

Patients with limited mobility due to ossification in the foot or other areas.

Billing Considerations

Orthopedic surgeons must consider the risks of surgery due to potential for further ossification.

Coding Guidelines

Inclusion Criteria

Use M61.175 When
  • Follow the ICD
  • CM coding guidelines for myositis and ensure that the specific site of ossification is documented
  • Include any relevant family history and genetic testing results to support the diagnosis

Exclusion Criteria

Do NOT use M61.175 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

97001CPT Code

Physical therapy evaluation

Clinical Scenario

Used for assessing functional limitations due to myositis ossificans.

Documentation Requirements

Detailed evaluation of muscle strength and range of motion.

Specialty Considerations

Physical therapists should document the impact of the condition on daily activities.

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 ossificans progressiva overview

Coding & Billing References

  • •
    Myositis ossificans progressiva 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 soft tissues, leading to progressive muscle weakness and functional impairment.