ICD Code M61.011

ICD code M61.011 is used to identify a condition known as myositis ossificans traumatica affecting the right shoulder. This condition involves the abnormal formation of bone tissue within the muscle, typically as a result of trauma or injury. The presence of this code in medical documentation helps healthcare providers and billing specialists accurately capture the diagnosis for treatment planning and insurance claims processing. By specifying the right shoulder, the code ensures precise localization of the condition, which is crucial for effective management and reimbursement.

When to use the ICD code for Myositis ossificans traumatica, right shoulder:

1. History of Trauma: Documented history of trauma or injury to the right shoulder, such as a fracture, dislocation, or significant soft tissue injury.

2. Symptoms of Pain: Patient reports localized pain in the right shoulder, which may be exacerbated by movement or pressure.

3. Swelling and Inflammation: Presence of swelling, tenderness, or warmth in the affected area, indicating inflammation.

4. Limited Range of Motion: Observed or reported limitation in the range of motion of the right shoulder, affecting daily activities.

5. Radiological Evidence: Imaging studies (e.g., X-rays, MRI) show the presence of calcification or ossification in the soft tissues of the right shoulder.

6. Exclusion of Other Conditions: Differential diagnosis has ruled out other potential causes of shoulder pain and ossification, such as infections, tumors, or other inflammatory conditions.

7. Chronic Symptoms: Symptoms persisting beyond the expected healing time for the initial injury, indicating a potential complication such as myositis ossificans.

8. Physical Examination Findings: Clinical examination reveals specific findings consistent with myositis ossificans, such as palpable masses or abnormal muscle tone in the affected area.

9. Patient History: Consideration of any underlying conditions or previous episodes of myositis ossificans that may predispose the patient to this diagnosis.

By adhering to these diagnostic criteria and symptoms, healthcare providers can accurately determine the appropriate use of the ICD code for myositis ossificans traumatica of the right shoulder.

For the ICD code M61.011, which pertains to myositis ossificans traumatica of the right shoulder, the relevant CPT codes that may be applicable for treatment include:

1. 20550 - Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar "fascia").

2. 20610 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa); without ultrasound guidance.

3. 24357 - Tenotomy, shoulder area; percutaneous.

4. 24358 - Tenotomy, shoulder area; open.

5. 24359 - Tenotomy, shoulder area; open, with tendon transfer.

6. 24360 - Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; acute.

7. 24361 - Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; chronic.

8. 24362 - Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; with graft.

These CPT codes are examples of procedures that might be considered in the management of myositis ossificans traumatica of the right shoulder, depending on the specific clinical scenario and treatment plan. Always consult with a healthcare professional or coding specialist to ensure accurate coding based on the specific details of the case.

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