ICD Code M61.411

ICD code M61.411 is used to identify a medical condition characterized by the presence of abnormal calcium deposits in the muscle tissue of the right shoulder. This condition, known as calcification, can lead to pain, stiffness, and reduced mobility in the affected area. The code helps healthcare providers document and communicate the specific location and nature of the calcification for accurate diagnosis, treatment planning, and billing purposes.

When to use the ICD code M61411 for Other calcification of muscle, right shoulder, consider the following diagnostic criteria and symptoms:

1. Presence of Calcification: Evidence of abnormal calcification in the muscle tissue of the right shoulder, confirmed through imaging studies such as X-rays or MRI.

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

3. Reduced Range of Motion: Assessment reveals a decreased range of motion in the right shoulder joint, impacting daily activities.

4. Muscle Weakness: Patient exhibits weakness in the muscles surrounding the right shoulder, affecting strength and functionality.

5. Swelling or Inflammation: Observation of swelling or signs of inflammation in the right shoulder region during physical examination.

6. History of Trauma or Overuse: Patient has a history of trauma, repetitive strain, or overuse injuries to the right shoulder that may contribute to calcification.

7. Exclusion of Other Conditions: Differential diagnosis confirms that other potential causes of shoulder pain and calcification (e.g., arthritis, tendonitis) have been ruled out.

8. Chronic Symptoms: Symptoms have persisted for an extended period, typically more than a few weeks, indicating a chronic condition rather than an acute injury.

9. Functional Impairment: The condition leads to significant functional impairment in the patient's ability to perform daily tasks or occupational duties.

10. Response to Conservative Treatment: Lack of improvement or resolution of symptoms despite conservative treatment measures, such as physical therapy or anti-inflammatory medications.

These criteria should guide healthcare providers in determining the appropriate use of the ICD code for accurate documentation and billing purposes.

For the ICD code M61.411, which pertains to other calcification of muscle in the right shoulder, the relevant CPT codes that could be considered for treatment or diagnostic procedures include:

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

2. 20551 - Injection(s); single tendon origin/insertion.

3. 20610 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa); without ultrasound guidance.

4. 20611 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa); with ultrasound guidance, with permanent recording and reporting.

5. 73030 - Radiologic examination, shoulder; complete, minimum of two views.

6. 73221 - Magnetic resonance (e.g., proton) imaging, any joint of upper extremity; without contrast material(s).

These CPT codes are examples of procedures that might be performed to diagnose or treat conditions associated with the ICD code M61.411. It's important for healthcare providers to select the appropriate CPT code based on the specific clinical scenario and services provided.

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments for CPT codes associated with ICD code M61411. Schedule a demo today to see how RevFind can ensure you're receiving the full reimbursement you deserve.