ICD Code M61.119

ICD code M61119 is used to identify a condition known as myositis ossificans progressiva affecting an unspecified shoulder. Myositis ossificans progressiva is a rare disorder characterized by the abnormal development of bone tissue within muscles, tendons, and other soft tissues. This particular code indicates that the condition is present in the shoulder area, but it does not specify whether it is the left or right shoulder. This code is crucial for healthcare providers to accurately document and communicate the diagnosis for treatment planning and billing purposes.

When to use the ICD code M61119, Myositis ossificans progressiva, unspecified shoulder:

1. Diagnosis Confirmation: The patient has been clinically diagnosed with myositis ossificans progressiva based on medical evaluation and history.

2. Symptoms Present:

- Progressive muscle stiffness or weakness in the shoulder area.

- Pain or discomfort in the shoulder joint.

- Limited range of motion in the shoulder.

- Swelling or tenderness in the affected area.

3. Imaging Findings: Radiological evidence (e.g., X-rays, MRI) shows abnormal bone formation in the soft tissues around the shoulder.

4. Exclusion of Other Conditions: Other potential causes of shoulder pain and ossification have been ruled out, including trauma, infections, or other musculoskeletal disorders.

5. Progressive Nature: The condition is characterized by a progressive increase in symptoms and physical findings over time.

6. Patient History: The patient may have a family history of myositis ossificans progressiva or related connective tissue disorders.

7. Age Consideration: The diagnosis is typically made in young adults or adolescents, aligning with the common age of onset for this condition.

8. Clinical Evaluation: The healthcare provider has conducted a thorough clinical evaluation, including physical examination and assessment of functional limitations related to the shoulder.

By adhering to these diagnostic criteria and symptoms, healthcare providers can accurately determine when to utilize the ICD code M61119 in their documentation and billing processes.

For the ICD code M61.119, which pertains to myositis ossificans progressiva of an unspecified 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. 24341 - Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff).

7. 24342 - Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft.

These CPT codes are examples of procedures that might be considered in the management of conditions associated with myositis ossificans progressiva in the shoulder area. It is important for healthcare providers to select the appropriate CPT code based on the specific treatment plan and clinical scenario.

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