ICD Code M61.012

ICD code M61.012 is used to identify a medical condition known as "Myositis ossificans traumatica" specifically affecting the left shoulder. This condition involves the abnormal formation of bone tissue within the muscle, typically as a result of trauma or injury. It can lead to pain, swelling, and reduced mobility in the affected area. The code helps healthcare providers accurately document and communicate the diagnosis for treatment planning and billing purposes.

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

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

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

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

4. Limited Range of Motion: Observed or reported restriction in the range of motion of the left shoulder joint.

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

6. Exclusion of Other Conditions: Differential diagnosis has ruled out other potential causes of shoulder pain and swelling, such as rotator cuff injuries, bursitis, or arthritis.

7. Chronic Symptoms: Symptoms persisting beyond the expected recovery time from the initial trauma, indicating a potential complication such as myositis ossificans.

8. Functional Impairment: Evidence of functional impairment in daily activities due to the condition affecting the left shoulder.

These criteria should be carefully evaluated to determine the appropriate use of the ICD code in clinical documentation and billing processes.

For the ICD code M61.012, which pertains to myositis ossificans traumatica of the left 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. 24300 - Manipulation, shoulder joint, under anesthesia.

4. 24310 - Tenotomy, shoulder area; single tendon.

5. 24320 - Tenolysis, shoulder area; single tendon.

6. 24330 - Release of contracture, elbow or shoulder, with or without manipulation; with anesthesia.

7. 24340 - Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff).

8. 24341 - Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, secondary, with graft (includes obtaining graft).

These CPT codes are examples of procedures that may be performed to address the condition associated with ICD code M61.012. The selection of the appropriate CPT code will depend on the specific treatment plan and procedures performed by the healthcare provider. Always consult with a coding specialist or refer to the latest CPT coding guidelines to ensure accurate coding and billing.

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