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v1.0.0
ICD-10 Guide
ICD-10 CodesM61.459

M61.459

Billable

Other calcification of muscle, unspecified thigh

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

Code Description

ICD-10 M61.459 is a billable code used to indicate a diagnosis of other calcification of muscle, unspecified thigh.

Key Diagnostic Point:

Calcification of muscle refers to the abnormal deposition of calcium salts in muscle tissue, which can lead to stiffness, pain, and impaired function. In the case of unspecified thigh muscle calcification, the condition may arise from various underlying causes, including trauma, inflammation, or metabolic disorders. Myositis, an inflammatory condition of the muscles, can sometimes lead to calcification as a result of chronic inflammation. Muscle weakness may also be a symptom associated with calcification, as the affected muscles may not function optimally. Neuromuscular conditions can further complicate the clinical picture, as they may contribute to muscle degeneration or dysfunction. Diagnosis typically involves imaging studies, such as X-rays or MRI, to visualize the calcification and assess its extent. Treatment may vary based on the underlying cause and can include physical therapy, medications to manage pain and inflammation, or surgical intervention in severe cases. Accurate coding is essential for proper management and reimbursement, as it reflects the complexity of the patient's condition and the care provided.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in underlying causes of calcification
  • Need for precise documentation of symptoms and history
  • Differentiation from other muscle disorders
  • Potential for co-existing conditions

Audit Risk Factors

  • Insufficient documentation of the underlying cause
  • Inconsistent coding of muscle weakness or myositis
  • Failure to document co-existing conditions
  • Inadequate imaging reports to support diagnosis

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

Detailed history of symptoms, physical examination findings, and imaging results.

Common Clinical Scenarios

Patients presenting with muscle pain and weakness, particularly following inflammatory conditions.

Billing Considerations

Ensure that all relevant laboratory and imaging studies are documented to support the diagnosis.

Orthopedics

Documentation Requirements

Comprehensive assessment of muscle function, imaging studies, and treatment plans.

Common Clinical Scenarios

Patients with calcification following trauma or surgery.

Billing Considerations

Document any surgical interventions or physical therapy recommendations clearly.

Coding Guidelines

Inclusion Criteria

Use M61.459 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the code is used only when the specific site of calcification is not documented
  • Include all relevant clinical information to support the diagnosis

Exclusion Criteria

Do NOT use M61.459 When
No specific exclusions found.

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

Document the reason for imaging and findings.

Specialty Considerations

Ensure that the imaging report is included in the patient's record.

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 diagnosis and treatment tracking. M61.459 provides a means to capture cases where the specific site is not documented, but still requires attention.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of muscle calcification, improving the accuracy of diagnosis and treatment tracking. M61.459 provides a means to capture cases where the specific site is not documented, but still requires attention.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of muscle calcification, improving the accuracy of diagnosis and treatment tracking. M61.459 provides a means to capture cases where the specific site is not documented, but still requires attention.

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 like myositis, metabolic disorders, and prolonged immobilization.

How is muscle calcification diagnosed?

Diagnosis typically involves imaging studies such as X-rays or MRI to visualize the calcification and assess its extent.

What treatments are available for muscle calcification?

Treatment may include physical therapy, medications for pain and inflammation, or surgical intervention in severe cases.