M61.121: Myositis ossificans progressiva, right upper arm
M61.121, myositis ossificans progressiva, right upper arm, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 10 HCPCS Level II codes, including J3489 (Injection, zoledronic acid, 1 mg), J1740 (Injection, ibandronate sodium, 1 mg), J2430 (Injection, pamidronate disodium, per 30 mg). The articles come from 2 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with M61.121 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J3489 | Injection, zoledronic acid, 1 mg | Carrier judgment | — | 1 |
| J1740 | Injection, ibandronate sodium, 1 mg | Carrier judgment | — | 1 |
| J2430 | Injection, pamidronate disodium, per 30 mg | Special coverage instructions apply | — | 1 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 2 |
| G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0158 | Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0160 | Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G2169 | Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 1 |
Medicare policy articles listing M61.121
- A56907: Billing and Coding: Bisphosphonate Drug Therapy (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L34648
- A53057: Billing and Coding: Home Health Occupational Therapy (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34560
- A53064: Billing and Coding: Outpatient Occupational Therapy (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34427
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other M61 diagnoses (Calcification and ossification of muscle)
- M61.122 — Myositis ossificans progressiva, left upper arm
- M61.111 — Myositis ossificans progressiva, right shoulder
- M61.112 — Myositis ossificans progressiva, left shoulder
- M61.131 — Myositis ossificans progressiva, right forearm
- M61.132 — Myositis ossificans progressiva, left forearm
- M61.141 — Myositis ossificans progressiva, right hand
- M61.142 — Myositis ossificans progressiva, left hand
- M61.144 — Myositis ossificans progressiva, right finger(s)
- M61.145 — Myositis ossificans progressiva, left finger(s)
- M61.151 — Myositis ossificans progressiva, right thigh
- M61.152 — Myositis ossificans progressiva, left thigh
- M61.161 — Myositis ossificans progressiva, right lower leg
- M61.162 — Myositis ossificans progressiva, left lower leg
- M61.171 — Myositis ossificans progressiva, right ankle
- M61.172 — Myositis ossificans progressiva, left ankle
- M61.174 — Myositis ossificans progressiva, right foot
- M61.175 — Myositis ossificans progressiva, left foot
- M61.177 — Myositis ossificans progressiva, right toe(s)
- M61.178 — Myositis ossificans progressiva, left toe(s)
- M61.18 — Myositis ossificans progressiva, other site
- M61.19 — Myositis ossificans progressiva, multiple sites
- M61.011 — Myositis ossificans traumatica, right shoulder
- M61.012 — Myositis ossificans traumatica, left shoulder
- M61.021 — Myositis ossificans traumatica, right upper arm
- M61.022 — Myositis ossificans traumatica, left upper arm
- M61.031 — Myositis ossificans traumatica, right forearm
- M61.032 — Myositis ossificans traumatica, left forearm
- M61.041 — Myositis ossificans traumatica, right hand
- M61.042 — Myositis ossificans traumatica, left hand
- M61.051 — Myositis ossificans traumatica, right thigh
Frequently asked questions
Does Medicare cover M61.121 (Myositis ossificans progressiva, right upper arm)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list M61.121 as a covered diagnosis for 10 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 M61.121?
The Level II codes from the policies most specific to this diagnosis are J3489 (Injection, zoledronic acid, 1 mg, 1 article); J1740 (Injection, ibandronate sodium, 1 mg, 1 article); J2430 (Injection, pamidronate disodium, per 30 mg, 1 article); G0283 (Electrical stimulation (unattended), to one or more areas…, 2 articles); G0152 (Services performed by a qualified occupational therapist…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list M61.121?
A56907 (Billing and Coding: Bisphosphonate Drug Therapy); A53057 (Billing and Coding: Home Health Occupational Therapy); A53064 (Billing and Coding: Outpatient Occupational Therapy).
What is ICD-10-CM code M61.121?
M61.121 is the ICD-10-CM code for myositis ossificans progressiva, right upper arm, in category M61 (Calcification and ossification of muscle), chapter 13: Diseases of the musculoskeletal system and connective tissue.
Next steps
- Run a reimbursement report for a device billed under J3489
- Watch J3489 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3489
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 13: Diseases of the musculoskeletal system and connective tissue · All diagnoses · HCPCS lookup