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ICD-10 Guide
ICD-10 CodesM61.54

M61.54

Billable

Other ossification of muscle, hand

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

Code Description

ICD-10 M61.54 is a billable code used to indicate a diagnosis of other ossification of muscle, hand.

Key Diagnostic Point:

M61.54 refers to a condition characterized by abnormal ossification or calcification of muscle tissue in the hand. This condition can arise from various underlying factors, including trauma, chronic inflammation, or certain neuromuscular disorders. The ossification process leads to the replacement of muscle fibers with bone-like tissue, which can result in stiffness, pain, and reduced range of motion in the affected area. Patients may experience muscle weakness and functional impairment, particularly in activities requiring fine motor skills. The condition can be associated with myositis, where inflammation of the muscle tissue occurs, potentially complicating the clinical picture. Diagnosis typically involves imaging studies such as X-rays or MRI to visualize the ossified areas and differentiate them from other musculoskeletal conditions. Treatment may include physical therapy, pain management, and in some cases, surgical intervention to remove the ossified tissue if it severely impacts function.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to ossification
  • Differentiation from other muscle disorders
  • Potential for co-existing conditions like myositis
  • Need for precise documentation of symptoms and imaging findings

Audit Risk Factors

  • Inadequate documentation of symptoms and functional limitations
  • Failure to specify the location of ossification
  • Misclassification of the condition as a more common muscle disorder
  • Lack of imaging documentation to support the diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with pain and stiffness in the hand following trauma or with a history of myositis.

Billing Considerations

Ensure that the documentation clearly outlines the functional impact of the ossification on the patient's daily activities.

Rheumatology

Documentation Requirements

Comprehensive assessment of inflammatory markers and muscle strength testing.

Common Clinical Scenarios

Patients with autoimmune conditions presenting with muscle weakness and ossification.

Billing Considerations

Document any systemic symptoms that may indicate an underlying rheumatologic condition.

Coding Guidelines

Inclusion Criteria

Use M61.54 When
  • According to ICD
  • 10 guidelines, M61
  • 54 should be used when there is clear documentation of ossification in the muscle of the hand, with specific details on the affected muscles and any associated conditions

Exclusion Criteria

Do NOT use M61.54 When
  • Exclusion criteria include conditions that do not involve ossification

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used when joint aspiration is needed due to associated pain or swelling.

Documentation Requirements

Document the reason for aspiration and findings during the procedure.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is justified based on clinical findings.

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 M61.54, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M61.54, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 symptoms associated with M61.54?

Common symptoms include pain, stiffness, and reduced range of motion in the hand, often accompanied by muscle weakness.

How is M61.54 diagnosed?

Diagnosis typically involves clinical evaluation and imaging studies such as X-rays or MRI to identify ossified areas in the muscle.