ICD-10 Coding for Myositis(M60.0, M33.2, G72.41)
Complete ICD-10-CM coding and documentation guide for Myositis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Myositis
M60-M63Primary Range
Disorders of muscles
This range includes codes for various types of myositis, including infective and non-infective forms.
Dermatopolymyositis
This range covers specific types of inflammatory myopathies like polymyositis and dermatomyositis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M60.0 | Infective myositis | Use when myositis is due to an infection confirmed by culture. |
|
| M33.2 | Polymyositis | Use for autoimmune myositis without specific organ involvement. |
|
| G72.41 | Inclusion body myositis | Use when biopsy confirms inclusion bodies. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for polymyositis
Essential facts and insights about Myositis
Primary ICD-10-CM Codes for myositis
Decision Criteria
clinical Criteria
- Presence of infection confirmed by culture
Applicable To
- Muscle abscess
Excludes
- Non-infective myositis
Clinical Validation Requirements
- Purulent drainage from muscle
- Positive culture for pathogen
Code-Specific Risks
- Misidentifying non-infective causes as infective
Coding Notes
- Ensure infection is confirmed by lab results.
M33.2 - Polymyositis
Use for autoimmune myositis without specific organ involvement.
Applicable To
- Chronic inflammatory myopathy
Excludes
- Inclusion body myositis
Clinical Validation Requirements
- Elevated CK levels
- Muscle biopsy showing inflammation
Coding Notes
Document muscle biopsy and CK levels.
G72.41 - Inclusion body myositis
Use when biopsy confirms inclusion bodies.
Applicable To
- Sporadic inclusion body myositis
Excludes
- Polymyositis
Clinical Validation Requirements
- Biopsy showing rimmed vacuoles
- Weakness in finger flexors
Coding Notes
Ensure biopsy results are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Myositis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M60.0.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Use specific muscle strength grading, Include detailed clinical findings
Impact
Reimbursement: May lead to denied claims due to lack of specificity., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Always specify the site of myositis in documentation.
Impact
Reimbursement: Claims may be rejected for incomplete coding., Compliance: Fails to meet coding standards for specificity., Data Quality: Compromises the integrity of infection data.
Mitigation Strategy
Ensure lab results confirm the pathogen and code it.
Impact
Failure to document pathogen can lead to audit issues.
Mitigation Strategy
Ensure lab results confirming pathogen are included in the documentation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Myositis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Myositis
Use these documentation templates to ensure complete and accurate documentation for Myositis. These templates include all required elements for proper coding and billing.
Polymyositis with interstitial lung disease
Specialty: RheumatologyRequired Elements
- Patient history
- Physical examination findings
- Lab results
- Imaging studies
- Biopsy results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Myositis? Ask your questions below.