ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesM61.56

M61.56

Billable

Other ossification of muscle, lower leg

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

Code Description

ICD-10 M61.56 is a billable code used to indicate a diagnosis of other ossification of muscle, lower leg.

Key Diagnostic Point:

M61.56 refers to a condition characterized by abnormal bone formation within the muscle tissue of the lower leg. This ossification can occur due to various factors, including trauma, inflammation, or certain myopathies. The condition may lead to muscle stiffness, pain, and reduced range of motion, significantly impacting the patient's mobility and quality of life. In some cases, it may be associated with myositis, where muscle inflammation contributes to the ossification process. Clinicians must differentiate this condition from other muscle disorders, such as muscular dystrophies or neuromuscular conditions, which may present with similar symptoms but have different underlying pathophysiologies. Diagnosis typically involves imaging studies, such as X-rays or MRIs, to visualize the ossified areas and assess the extent of the condition. Treatment may include physical therapy, pain management, and in some cases, surgical intervention to remove the ossified tissue if it severely limits function.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other muscle disorders
  • Need for precise documentation of symptoms and imaging results
  • Potential overlap with myositis and other inflammatory conditions
  • Variability in clinical presentation among patients

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the location of ossification
  • Misdiagnosis due to overlapping symptoms with other conditions
  • Lack of imaging studies to support the diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, clinical notes on range of motion, and pain assessments.

Common Clinical Scenarios

Patients presenting with lower leg pain and stiffness post-trauma or surgery.

Billing Considerations

Orthopedic surgeons should document the extent of ossification and its impact on mobility.

Rheumatology

Documentation Requirements

Comprehensive history of inflammatory conditions, lab results, and response to treatment.

Common Clinical Scenarios

Patients with myositis presenting with muscle weakness and ossification.

Billing Considerations

Rheumatologists must differentiate between primary muscle disorders and secondary ossification due to inflammation.

Coding Guidelines

Inclusion Criteria

Use M61.56 When
  • According to ICD
  • 10 guidelines, M61
  • 56 should be used when there is clear documentation of ossification in the lower leg muscles
  • It is important to include the cause of ossification, if known, and to rule out other conditions that may mimic the symptoms

Exclusion Criteria

Do NOT use M61.56 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 a patient with ossification also presents with joint effusion.

Documentation Requirements

Document the reason for the procedure and the findings during the aspiration.

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 M61.56, 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 M61.56, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of patient outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like M61.56, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of patient outcomes 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 symptoms associated with M61.56?

Common symptoms include pain, stiffness, and reduced range of motion in the affected lower leg muscles. Patients may also experience muscle weakness and difficulty with mobility.