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ICD-10 Guide
ICD-10 CodesM61.176

M61.176

Billable

Myositis ossificans progressiva, unspecified foot

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

Code Description

ICD-10 M61.176 is a billable code used to indicate a diagnosis of myositis ossificans progressiva, unspecified foot.

Key Diagnostic Point:

Myositis ossificans progressiva (MOP) is a rare genetic disorder characterized by the abnormal formation of bone in muscles and connective tissues. This condition typically begins in early childhood and progresses over time, leading to significant muscle stiffness and weakness. In the case of unspecified foot involvement, patients may experience pain, swelling, and reduced mobility in the affected foot due to the ossification process. 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. Patients may present with episodes of soft tissue swelling followed by the development of bony masses, which can severely limit joint movement and function. Management focuses on symptomatic relief, physical therapy, and avoiding trauma to the affected areas, as injury can exacerbate ossification. Understanding the nuances of myositis ossificans progressiva is essential for accurate coding and effective patient management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Rarity of the condition makes documentation less common.
  • Need for precise clinical details to differentiate from other myositis types.
  • Potential for misdiagnosis with other musculoskeletal disorders.
  • Genetic testing documentation may be required for accurate coding.

Audit Risk Factors

  • Inadequate documentation of genetic testing results.
  • Failure to specify the affected area (e.g., foot vs. other locations).
  • Misclassification with other types of myositis or muscle disorders.
  • Lack of comprehensive clinical notes detailing the progression of the condition.

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

Detailed clinical notes on symptoms, progression, and treatment response.

Common Clinical Scenarios

Patients presenting with muscle stiffness and swelling, particularly after trauma.

Billing Considerations

Documentation should include family history and genetic testing results.

Genetics

Documentation Requirements

Genetic test results and family pedigree charts.

Common Clinical Scenarios

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

Billing Considerations

Ensure clear linkage between genetic findings and clinical symptoms.

Coding Guidelines

Inclusion Criteria

Use M61.176 When
  • Follow ICD
  • CM guidelines for coding myositis ossificans
  • Ensure accurate documentation of the condition's progression and any related genetic testing

Exclusion Criteria

Do NOT use M61.176 When
  • Exclude other myositis types unless specified

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

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

Documentation Requirements

Document patient history, examination findings, and treatment plan.

Specialty Considerations

Rheumatology specialists should ensure comprehensive notes on symptom progression.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of myositis ossificans, improving the accuracy of data collection and reimbursement processes. M61.176 provides a clear designation for unspecified foot involvement, which aids in clinical management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of myositis ossificans, improving the accuracy of data collection and reimbursement processes. M61.176 provides a clear designation for unspecified foot involvement, which aids in clinical management and research.

Reimbursement & Billing Impact

reimbursement processes. M61.176 provides a clear designation for unspecified foot involvement, which aids in clinical management and research.

Resources

Clinical References

  • •
    Myositis Association

Coding & Billing References

  • •
    Myositis Association

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.