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ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 M61.011

Billable / Specific

Myositis ossificans traumatica, right shoulder

M61
Block
0
Synonyms
230
LCDs
5
Payer Policies
3
Linked CPTs

About ICD-10-CM M61.011

ICD-10-CM code M61.011 represents Myositis ossificans traumatica, right shoulder. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M61). The 2026 edition of ICD-10-CM M61.011 became effective on October 1, 2025.

Medicare LCD Coverage for M61.011

Local Coverage Determinations (LCDs) from CMS MACs that list M61.011 as a covered diagnosis.

230 LCDs

Showing top 10 of 230 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29131 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29260 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29580 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97036 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29445 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97542 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97110 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97533 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29130 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29405 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M61.011.

5 policies

5 Medicare

Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065
Billing and Coding: Bisphosphonate Drug Therapy
Policy ID: ART-56907
Billing and Coding: Bisphosphonate Drug Therapy
Policy ID: ART-59561

CPT Codes Commonly Billed with M61.011

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

3 linkages
  • J2430 CMS LCD: Billing and Coding: Bisphosphonate Drug Therapy CMS LCD
  • J1740 CMS LCD: Billing and Coding: Bisphosphonate Drug Therapy CMS LCD
  • J3489 CMS LCD: Billing and Coding: Bisphosphonate Drug Therapy CMS LCD

Convert M61.011 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
M61.011 72812 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To M61.011

Other codes in section M60-M63 (Disorders of muscles).

M60 Myositis (non-billable) M60.0 Infective myositis (non-billable) M60.00 Infective myositis, unspecified site (non-billable) M60.000 Infective myositis, unspecified right arm M60.001 Infective myositis, unspecified left arm M60.002 Infective myositis, unspecified arm M60.003 Infective myositis, unspecified right leg M60.004 Infective myositis, unspecified left leg M60.005 Infective myositis, unspecified leg M60.009 Infective myositis, unspecified site M60.01 Infective myositis, shoulder (non-billable) M60.011 Infective myositis, right shoulder M60.012 Infective myositis, left shoulder M60.019 Infective myositis, unspecified shoulder M60.02 Infective myositis, upper arm (non-billable) M60.021 Infective myositis, right upper arm M60.022 Infective myositis, left upper arm M60.029 Infective myositis, unspecified upper arm M60.03 Infective myositis, forearm (non-billable) M60.031 Infective myositis, right forearm

ICD-10 M61.011, Billing FAQ

Is ICD-10 code M61.011 billable? +

Yes, M61.011 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with M61.011? +

Procedures frequently paired with M61.011 include: J2430, J1740, J3489.

What ICD-9 codes does M61.011 map to? +

Per CMS GEMs, M61.011 maps to ICD-9 codes: 72812. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on July 16, 2026.

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