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ICD-10 Guide
ICD-10 CodesM61.177

M61.177

Billable

Myositis ossificans progressiva, right toe(s)

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

Code Description

ICD-10 M61.177 is a billable code used to indicate a diagnosis of myositis ossificans progressiva, right toe(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 manifests after minor trauma or injury, leading to painful swelling and stiffness in the affected area. In the case of M61.177, the ossification occurs specifically in the right toe(s), which can severely limit mobility and function. Patients may experience muscle weakness due to the progressive nature of the condition, as the ossification replaces normal muscle tissue with bone, leading to decreased muscle mass and strength. The condition is often misdiagnosed due to its rarity and the overlap of symptoms with other musculoskeletal disorders. Diagnosis is primarily clinical, supported by imaging studies that reveal the presence of heterotopic ossification. Management focuses on symptomatic relief, physical therapy, and in some cases, surgical intervention to remove the ossified tissue. 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 precise documentation of symptoms and imaging findings.
  • Differentiation from other myositis and ossification disorders.
  • Potential for multiple affected sites complicating coding.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to specify the affected site accurately.
  • Misinterpretation of imaging results.
  • Inconsistent coding across different encounters.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with pain and swelling in the toe(s) after minor trauma.

Billing Considerations

Documentation should clearly outline the progression of symptoms and any interventions performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Assessment of functional limitations and rehabilitation goals.

Common Clinical Scenarios

Patients requiring physical therapy for mobility improvement.

Billing Considerations

Focus on documenting the impact of the condition on daily activities and rehabilitation progress.

Coding Guidelines

Inclusion Criteria

Use M61.177 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's specifics, including the affected site
  • Include any relevant history of trauma and the patient's clinical presentation

Exclusion Criteria

Do NOT use M61.177 When
  • Exclude conditions that do not meet the criteria for myositis ossificans progressiva

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used when aspiration is needed for symptomatic relief in cases of swelling.

Documentation Requirements

Document the reason for aspiration and any findings during the procedure.

Specialty Considerations

Orthopedic specialists should note the joint involved and any prior treatments.

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 data accuracy and patient management. The specificity of M61.177 helps in tracking the condition's prevalence and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like myositis ossificans progressiva, improving data accuracy and patient management. The specificity of M61.177 helps in tracking the condition's prevalence and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like myositis ossificans progressiva, improving data accuracy and patient management. The specificity of M61.177 helps in tracking the condition's prevalence and treatment outcomes.

Resources

Clinical References

  • •
    Myositis Ossificans Progressiva Foundation

Coding & Billing References

  • •
    Myositis Ossificans Progressiva Foundation

Frequently Asked Questions

What are the common symptoms of myositis ossificans progressiva?

Common symptoms include swelling, pain, and stiffness in the affected area, often following minor trauma. Patients may also experience muscle weakness and limited mobility.