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ICD-10 Guide
ICD-10 CodesM61.421

M61.421

Billable

Other calcification of muscle, right upper arm

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

Code Description

ICD-10 M61.421 is a billable code used to indicate a diagnosis of other calcification of muscle, right upper arm.

Key Diagnostic Point:

M61.421 refers to the condition characterized by abnormal calcification within the muscle tissue of the right upper arm. This condition can arise from various underlying causes, including trauma, inflammation, or metabolic disorders. Calcification in muscle can lead to stiffness, pain, and reduced range of motion, impacting the patient's ability to perform daily activities. It may be associated with myositis, a condition where muscle inflammation occurs, leading to muscle weakness and discomfort. The calcification can be focal or diffuse and may be detected through imaging studies such as X-rays or MRI. Clinicians must consider the patient's history, including any previous injuries or systemic diseases, to determine the etiology of the calcification. Treatment may involve physical therapy, pain management, and addressing any underlying conditions contributing to the calcification. Accurate diagnosis and coding are essential for appropriate management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of muscle calcification
  • Understanding the underlying causes of calcification
  • Documenting associated symptoms and conditions
  • Navigating related codes for muscle disorders

Audit Risk Factors

  • Inadequate documentation of the calcification's etiology
  • Failure to specify the location of calcification
  • Misclassification of muscle disorders
  • Lack of supporting imaging studies

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, history of trauma, and physical examination findings.

Common Clinical Scenarios

Patients presenting with pain and stiffness in the right upper arm following an injury.

Billing Considerations

Consideration of differential diagnoses such as tendonitis or bursitis.

Rheumatology

Documentation Requirements

Comprehensive history of systemic symptoms, laboratory tests for autoimmune markers.

Common Clinical Scenarios

Patients with systemic inflammatory conditions presenting with localized muscle calcification.

Billing Considerations

Need to evaluate for other systemic conditions that may contribute to muscle calcification.

Coding Guidelines

Inclusion Criteria

Use M61.421 When
  • According to ICD
  • 10 guidelines, M61
  • 421 should be used when there is clear documentation of calcification in the right upper arm muscle
  • It is important to ensure that the documentation specifies the nature of the calcification and any associated symptoms or conditions

Exclusion Criteria

Do NOT use M61.421 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

73030CPT Code

Radiologic examination, shoulder, complete, including axillary and scapular views

Clinical Scenario

Used when imaging is required to assess calcification in the muscle.

Documentation Requirements

Imaging reports must be included in the patient's medical record.

Specialty Considerations

Orthopedic specialists often order these imaging studies.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of muscle calcification, improving the accuracy of diagnoses and treatment plans. M61.421 provides a clear indication of the location and nature of the condition, facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of muscle calcification, improving the accuracy of diagnoses and treatment plans. M61.421 provides a clear indication of the location and nature of the condition, facilitating better patient management.

Reimbursement & Billing Impact

reimbursement and to avoid claim denials.

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, inflammatory conditions, metabolic disorders, and certain systemic diseases that affect muscle tissue.

How is muscle calcification diagnosed?

Diagnosis typically involves imaging studies such as X-rays or MRI, along with a thorough clinical evaluation to assess symptoms and history.