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ICD-10 Guide
ICD-10 CodesM61.552

M61.552

Billable

Other ossification of muscle, left thigh

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

Code Description

ICD-10 M61.552 is a billable code used to indicate a diagnosis of other ossification of muscle, left thigh.

Key Diagnostic Point:

M61.552 refers to a condition characterized by abnormal bone formation within the muscle tissue of the left thigh. This ossification can occur due to various factors, including trauma, muscle injury, or certain myopathies. The presence of ossification can lead to muscle stiffness, pain, and reduced range of motion, significantly impacting the patient's mobility and quality of life. Clinically, patients may present with localized tenderness, swelling, and muscle weakness in the affected area. The condition can be associated with myositis, which is inflammation of the muscle, and may complicate the clinical picture. Diagnosis typically involves imaging studies such as X-rays or MRI to visualize the ossified areas and differentiate them from other muscle disorders. Treatment may include physical therapy, pain management, and in some cases, surgical intervention to remove the ossified tissue if it severely limits function. Understanding the underlying causes and associated conditions is crucial for effective management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating from other muscle disorders such as myositis or muscle strains.
  • Need for precise documentation of the location and extent of ossification.
  • Potential overlap with other ICD-10 codes related to muscle conditions.
  • Variability in clinical presentation and associated symptoms.

Audit Risk Factors

  • Inadequate documentation of the clinical findings.
  • Failure to include imaging results in the medical record.
  • Misinterpretation of the condition as a different muscle disorder.
  • Lack of clarity on the cause of ossification.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the patient's history, physical examination findings, and imaging results.

Common Clinical Scenarios

Patients presenting with pain and limited mobility in the thigh after trauma or surgery.

Billing Considerations

Ensure that the documentation clearly states the diagnosis and any associated conditions.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessment of functional limitations and treatment plans.

Common Clinical Scenarios

Patients undergoing rehabilitation for muscle weakness and stiffness due to ossification.

Billing Considerations

Document the impact of the condition on daily activities and rehabilitation progress.

Coding Guidelines

Inclusion Criteria

Use M61.552 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's specifics, including laterality and any associated conditions
  • Include any relevant imaging studies and clinical findings to support the diagnosis

Exclusion Criteria

Do NOT use M61.552 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 treating associated pain or inflammation in the thigh.

Documentation Requirements

Document the reason for the procedure and any imaging findings.

Specialty Considerations

Orthopedic specialists should ensure clear linkage between the procedure and the diagnosis.

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 M61.552, improving the accuracy of data collection and reimbursement processes. This specificity helps in better tracking of muscle disorders and their treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M61.552, improving the accuracy of data collection and reimbursement processes. This specificity helps in better tracking of muscle disorders and their treatment outcomes.

Reimbursement & Billing Impact

reimbursement processes. This specificity helps in better tracking of muscle disorders and their treatment outcomes.

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, prolonged immobilization, and certain myopathies. It can also occur post-surgery or in patients with inflammatory muscle conditions.