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ICD-10 Guide
ICD-10 CodesM61.512

M61.512

Billable

Other ossification of muscle, left shoulder

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

Code Description

ICD-10 M61.512 is a billable code used to indicate a diagnosis of other ossification of muscle, left shoulder.

Key Diagnostic Point:

M61.512 refers to a condition characterized by abnormal bone formation within the muscle tissue of the left shoulder. This condition, known as myositis ossificans, can occur following trauma, surgery, or in association with certain neuromuscular disorders. The ossification process leads to the replacement of muscle fibers with bone tissue, resulting in stiffness, pain, and reduced range of motion. Patients may experience muscle weakness and discomfort, particularly during movement. Diagnosis typically involves imaging studies such as X-rays or MRI to visualize the ossified areas. Treatment may include physical therapy, pain management, and in some cases, surgical intervention to remove the ossified tissue. Understanding the underlying causes, such as previous injuries or systemic conditions, is crucial for effective management and rehabilitation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of specific muscle disorders and their implications.
  • Differentiation from other musculoskeletal conditions.
  • Need for precise documentation of the location and extent of ossification.
  • Potential overlap with other codes related to muscle and bone disorders.

Audit Risk Factors

  • Inadequate documentation of the clinical findings.
  • Failure to specify the exact location of ossification.
  • Misclassification of the condition as a different muscle disorder.
  • Lack of supporting imaging studies in the medical record.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with shoulder pain and limited range of motion following trauma.

Billing Considerations

Documentation should clearly outline the history of injury and any previous treatments.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessment of functional limitations and rehabilitation goals.

Common Clinical Scenarios

Patients requiring rehabilitation post-surgery for ossification removal.

Billing Considerations

Focus on documenting progress and response to therapy.

Coding Guidelines

Inclusion Criteria

Use M61.512 When
  • According to ICD
  • 10 guidelines, M61
  • 512 should be used when there is clear documentation of ossification in the left shoulder muscle
  • It is important to ensure that the condition is not a result of other underlying diseases or injuries that may require different coding

Exclusion Criteria

Do NOT use M61.512 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 managing pain associated with ossification.

Documentation Requirements

Document the reason for the procedure and the findings.

Specialty Considerations

Orthopedic specialists should ensure accurate coding based on the procedure performed.

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 M61.512, improving the accuracy of diagnoses and treatment plans. This specificity aids in better patient management and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M61.512, improving the accuracy of diagnoses and treatment plans. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like M61.512, improving the accuracy of diagnoses and treatment plans. This specificity aids in better patient management and resource allocation.

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 ossification of muscle?

Common causes include trauma, surgery, and certain neuromuscular disorders. It can also occur spontaneously in some individuals.