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ICD-10 Guide
ICD-10 CodesM61.211

M61.211

Billable

Paralytic calcification and ossification of muscle, right shoulder

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

Code Description

ICD-10 M61.211 is a billable code used to indicate a diagnosis of paralytic calcification and ossification of muscle, right shoulder.

Key Diagnostic Point:

Paralytic calcification and ossification of muscle, particularly in the right shoulder, refers to the abnormal deposition of calcium salts in muscle tissue due to paralysis or disuse. This condition often arises in patients who have experienced significant muscle weakness or atrophy, typically following neuromuscular disorders, trauma, or prolonged immobilization. The calcification process can lead to stiffness, pain, and reduced range of motion in the affected shoulder. Clinically, it may present as a palpable mass or tenderness in the shoulder region, and imaging studies such as X-rays or MRI may be utilized to confirm the diagnosis. The underlying pathophysiology involves a complex interplay of muscle degeneration and the body’s response to injury, which can result in ectopic bone formation. Treatment often includes physical therapy, pain management, and in some cases, surgical intervention to remove calcified tissue. Understanding the etiology and management of this condition is crucial for effective patient care and accurate coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of muscle disorders and their implications.
  • Differentiation from other musculoskeletal conditions.
  • Need for precise documentation of the affected site.
  • Potential overlap with other ICD-10 codes related to muscle calcification.

Audit Risk Factors

  • Inadequate documentation of the clinical findings.
  • Failure to specify the affected muscle group.
  • Misinterpretation of imaging results.
  • Lack of correlation between diagnosis and treatment provided.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients with shoulder pain and limited mobility due to calcification.

Billing Considerations

Ensure that the documentation clearly states the relationship between paralysis and calcification.

Neurology

Documentation Requirements

Comprehensive history of neuromuscular disorders and their impact on muscle function.

Common Clinical Scenarios

Patients with neurological conditions leading to muscle weakness and subsequent calcification.

Billing Considerations

Document the neurological assessment and any relevant diagnostic tests performed.

Coding Guidelines

Inclusion Criteria

Use M61.211 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the condition is confirmed through clinical evaluation and imaging
  • Include any relevant co
  • morbidities that may affect treatment

Exclusion Criteria

Do NOT use M61.211 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

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

Clinical Scenario

Used when a patient with calcification in the shoulder requires aspiration of fluid or injection for pain relief.

Documentation Requirements

Document the indication for the procedure, including imaging findings and patient symptoms.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is justified based on the patient's condition.

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 M61.211, improving the accuracy of data collection and reimbursement processes. This specificity helps in better tracking of muscle disorders and their treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M61.211, improving the accuracy of data collection and reimbursement processes. This specificity helps in better tracking of muscle disorders and their treatment outcomes.

Reimbursement & Billing Impact

reimbursement processes. This specificity helps in better tracking of muscle disorders and their treatment outcomes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common causes of paralytic calcification?

Common causes include prolonged immobilization, neurological conditions such as stroke or spinal cord injury, and muscle disuse due to various medical conditions.