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ICD-10 Guide
ICD-10 CodesM61.411

M61.411

Billable

Other calcification of muscle, right shoulder

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

Code Description

ICD-10 M61.411 is a billable code used to indicate a diagnosis of other calcification of muscle, right shoulder.

Key Diagnostic Point:

M61.411 refers to the condition characterized by abnormal calcification in the muscle tissue of the right shoulder. This condition can arise from various underlying causes, including trauma, inflammation, or metabolic disorders. Calcification in muscle tissue may lead to pain, stiffness, and reduced range of motion, significantly impacting a patient's quality of life. It is often associated with myositis, a condition where muscle inflammation occurs, leading to muscle weakness and discomfort. Patients may present with localized pain in the shoulder, swelling, and tenderness upon palpation. Diagnostic imaging, such as X-rays or MRI, is typically utilized to confirm the presence of calcification and assess its extent. Treatment options may include physical therapy, pain management, and in some cases, surgical intervention to remove the calcified tissue. Understanding the etiology and implications of muscle calcification is crucial for effective management and coding of this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of muscle calcification
  • Understanding associated conditions like myositis
  • Need for precise documentation of symptoms and imaging results
  • Potential overlap with other musculoskeletal codes

Audit Risk Factors

  • Inadequate documentation of symptoms and imaging findings
  • Failure to specify the location of calcification
  • Misuse of related codes leading to incorrect billing
  • Lack of clarity on the underlying cause of calcification

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, clinical notes on physical examination, and treatment plans.

Common Clinical Scenarios

Patients presenting with shoulder pain and limited range of motion due to calcification.

Billing Considerations

Orthopedic specialists must document the functional impact of calcification on mobility and daily activities.

Rheumatology

Documentation Requirements

Comprehensive history of autoimmune conditions, lab results, and treatment responses.

Common Clinical Scenarios

Patients with myositis or other inflammatory conditions leading to muscle calcification.

Billing Considerations

Rheumatologists should focus on the systemic implications of muscle calcification and its relation to autoimmune disorders.

Coding Guidelines

Inclusion Criteria

Use M61.411 When
  • According to ICD
  • 10 guidelines, M61
  • 411 should be used when the calcification is specifically located in the right shoulder muscle
  • Coders must ensure that the documentation supports the diagnosis and that the calcification is not due to other conditions such as trauma or systemic diseases

Exclusion Criteria

Do NOT use M61.411 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

73030CPT Code

Radiologic examination, shoulder

Clinical Scenario

Used when imaging is performed to assess calcification in the shoulder.

Documentation Requirements

Radiology report detailing findings of calcification.

Specialty Considerations

Orthopedic specialists should ensure imaging correlates with clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specificity in coding muscle calcification, improving the accuracy of patient records and facilitating better treatment planning. M61.411 provides a clear distinction from other related conditions, enhancing the understanding of the patient's clinical picture.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding muscle calcification, improving the accuracy of patient records and facilitating better treatment planning. M61.411 provides a clear distinction from other related conditions, enhancing the understanding of the patient's clinical picture.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specificity in coding muscle calcification, improving the accuracy of patient records and facilitating better treatment planning. M61.411 provides a clear distinction from other related conditions, enhancing the understanding of the patient's clinical picture.

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 muscle calcification?

Common causes include trauma, chronic inflammation, metabolic disorders, and certain autoimmune conditions. Each cause may require different management strategies.