M61.212
BillableParalytic calcification and ossification of muscle, left shoulder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M61.212 an HCC code?
No. M61.212 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
M61.212 is the ICD-10-CM diagnosis code for paralytic calcification and ossification of muscle, left shoulder. Abnormal calcium deposits and bone formation in the muscles of the left shoulder, typically occurring after paralysis or severe injury. M61.212 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering disorders of muscles (m60-m63).
M61.212 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Confirm left shoulder laterality is explicitly documented in the clinical notes.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M61.212 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm left shoulder laterality is explicitly documented in the clinical notes
- •Consider whether this is a secondary condition related to a documented paralytic event or neurological condition