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ICD-10 Guide
ICD-10 CodesM61.45

M61.45

Billable

Other calcification of muscle, thigh

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

Code Description

ICD-10 M61.45 is a billable code used to indicate a diagnosis of other calcification of muscle, thigh.

Key Diagnostic Point:

M61.45 refers to the condition characterized by abnormal calcification in the muscle tissue of the thigh. This condition can arise from various underlying causes, including metabolic disorders, trauma, or inflammatory processes. Calcification in muscle can lead to stiffness, pain, and reduced mobility, significantly impacting a patient's quality of life. It may be associated with myositis, a condition where muscle inflammation occurs, leading to muscle weakness and discomfort. The calcification can be detected through imaging studies such as X-rays or MRI, which reveal the presence of calcium deposits in the muscle tissue. Clinicians must consider the patient's history, symptoms, and any potential underlying conditions when diagnosing and managing this disorder. Treatment may involve physical therapy, pain management, and addressing any underlying causes to prevent further calcification. Accurate coding is essential for proper reimbursement and to ensure that the patient's condition is adequately documented in their medical records.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to calcification
  • Differentiation from other muscle disorders
  • Need for precise documentation of symptoms and imaging results
  • Potential overlap with other ICD-10 codes for muscle disorders

Audit Risk Factors

  • Inadequate documentation of the underlying cause of calcification
  • Failure to document associated symptoms or functional limitations
  • Misclassification of the condition due to overlapping symptoms with myositis
  • Lack of imaging results to support the diagnosis

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

Detailed history of symptoms, imaging studies, and treatment plans.

Common Clinical Scenarios

Patients presenting with muscle pain and stiffness, particularly after trauma or in the context of autoimmune diseases.

Billing Considerations

Consideration of comorbid conditions that may contribute to calcification, such as metabolic disorders.

Orthopedics

Documentation Requirements

Comprehensive assessment of muscle function, imaging results, and treatment interventions.

Common Clinical Scenarios

Patients with calcification following orthopedic surgery or trauma to the thigh.

Billing Considerations

Documentation of any surgical interventions or rehabilitation efforts related to the calcification.

Coding Guidelines

Inclusion Criteria

Use M61.45 When
  • According to official coding guidelines, M61
  • 45 should be used when there is clear documentation of calcification in the thigh muscle, supported by imaging studies
  • related muscle injuries

Exclusion Criteria

Do NOT use M61.45 When
  • It is important to exclude other conditions that may present similarly, such as myositis or trauma

Related ICD-10 Codes

Related CPT Codes

73030CPT Code

Radiologic examination, thigh

Clinical Scenario

Used when imaging is performed to assess calcification in the thigh muscle.

Documentation Requirements

Radiology report detailing findings of calcification.

Specialty Considerations

Ensure that the imaging study is clearly linked to the diagnosis of calcification.

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 M61.45, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of patient outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M61.45, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of patient outcomes and resource allocation.

Reimbursement & Billing Impact

reimbursement.

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 imaging studies are necessary to support the diagnosis of M61.45?

Imaging studies such as X-rays or MRI are essential to confirm the presence of calcification in the thigh muscle. The radiology report should detail the findings and correlate them with the patient's symptoms.