Is M61.4 a billable ICD-10-CM code?

No. M61.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M61.4 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Disorders of muscles (M60-M63).

What cannot be coded together with M61.4?

M61.4 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

M61.4

M61.4 — Other calcification of muscle

Non-billable headerICD-10-CM

M61.4 is a non-billable header ICD-10-CM code for other calcification of muscle. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

calcific tendinitis NOS (M65.2-)
calcific tendinitis of shoulder (M75.3)

Risk adjustment

M61.4 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead M61.4

10 child codes. Green means billable.

Related codes at this level

Codes that share M61. If M61.4 is not quite right, the correct code is usually one of these.

Questions about M61.4

Is M61.4 a billable ICD-10-CM code?: No. M61.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M61.4 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Disorders of muscles (M60-M63).
What cannot be coded together with M61.4?: M61.4 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.