ICD-10-CM · Multi-region

M62.49

M62.49 identifies pathological muscle contracture — persistent, often irreversible shortening of muscle tissue — occurring at two or more distinct anatomical sites simultaneously.

Verified May 8, 2026 · 4 sources ↓

Status
Billable
Chapter
13
Related CPT
13
Region
Multi-region
Drawn from CDCICD10DataCMS

Documentation tips

What should appear in the chart to support M62.49.

Source · Editorial brief grounded in 4 cited references ↓

  • Name each affected muscle group and its anatomical site explicitly — 'bilateral hip flexor and bilateral knee flexor contractures' is billable; 'diffuse tightness' is not.
  • Distinguish contracture from spasm or tendon contracture: document passive range-of-motion deficits with goniometric measurements to confirm fixed shortening rather than dynamic restriction.
  • Record the underlying etiology (e.g., prolonged immobility, upper motor neuron lesion, prior trauma) — payers and auditors expect a clinical rationale linking cause to the multi-site pattern.
  • If conservative treatment has been attempted, document modalities tried (stretching program, splinting, therapy frequency) prior to authorizing more invasive interventions; this anchors medical necessity.
  • When imaging or EMG is ordered, link M62.49 explicitly in the order — CMS LCD A57478 lists it as a supporting diagnosis for nerve conduction and EMG studies.

Related CPT procedures

Procedure codes commonly billed with M62.49. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

Common coding pitfalls

The recurring mistakes coders make with M62.49 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

  • Billing M62.49 when only one site is involved: use the site-specific code (e.g., M62.461 right lower leg) — the 'multiple sites' designation requires documented contracture at two or more distinct anatomical locations.
  • Using M62.49 alongside M24.5– for the same joint: the Type 1 Excludes note at M62.4 prohibits this combination; assign only the code that reflects the primary pathology.
  • Coding M62.4 (the non-billable parent) instead of M62.49: M62.4 is not valid for reimbursement; always use the fully specified child code.
  • Confusing muscle contracture with muscle spasm (R25.2) or joint stiffness (M25.6–): contracture implies persistent structural shortening, not a transient or neurologically mediated event — the clinical note must support that distinction.
  • Omitting laterality detail in the notes even though M62.49 itself doesn't carry a laterality character: auditors still expect site documentation in the medical record to justify the multi-site claim.

Clinical context

Source · Editorial summary grounded in 4 cited references ↓

Use M62.49 when the clinical record documents fixed or semi-fixed muscle contractures affecting more than one discrete anatomical region. Classic orthopedic presentations include post-immobilization contractures spanning both the hip flexors and knee flexors after prolonged bed rest, or upper- and lower-extremity contractures following stroke, spinal cord injury, cerebral palsy, or severe burns. The key threshold: contracture must be documented at multiple sites — not just widespread muscle tightness or spasm.

M62.49 sits under parent code M62.4, which also includes contracture of tendon sheaths. A Type 1 Excludes note at the M62.4 level prohibits simultaneous use with contracture of joint (M24.5–). If the primary pathology is a joint contracture with secondary muscle involvement, M24.5– takes precedence. If true muscle contracture at multiple body regions is independently documented, M62.49 is the correct billable code.

This code supports medical necessity for nerve conduction studies and EMG (per CMS LCD A57478), physical and occupational therapy, serial casting, and surgical procedures such as muscle release or tendon lengthening. In inpatient settings, M62.49 groups to MS-DRG 555 (with MCC) or 556 (without MCC) under MS-DRG v43.0. If contractures are limited to a single, lateralizable site, drop to the appropriate site-specific M62.4x1/M62.4x2 code rather than using the multiple-sites designation.

Sibling codes

Other billable codes under M62.4 (laterality / anatomic variants).

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 4 cited references ↓

01When should I use M62.49 versus a site-specific M62.4 code?
Use M62.49 only when the clinician documents contracture at two or more distinct anatomical sites. If contracture is confined to one region — even bilaterally within that region — use the site-specific code with the appropriate laterality character (e.g., M62.461 right lower leg, M62.462 left lower leg).
02Can M62.49 and M24.5– be billed together?
No. A Type 1 Excludes note at the M62.4 level prohibits coding contracture of muscle (M62.4–) alongside contracture of joint (M24.5–) for the same encounter. Assign the code that reflects the primary documented pathology.
03Does M62.49 support medical necessity for EMG and nerve conduction studies?
Yes. CMS LCD A57478 lists M62.49 as a supporting ICD-10-CM code for nerve conduction studies and electromyography. Link the code explicitly in the order and document the clinical rationale.
04What MS-DRG does M62.49 map to in the inpatient setting?
Under MS-DRG v43.0, M62.49 groups to DRG 555 (Signs and symptoms of musculoskeletal system and connective tissue with MCC) or DRG 556 (without MCC), depending on whether a qualifying major comorbidity or complication is documented.
05Is there a distinction between coding muscle contracture and tendon contracture under M62.4?
No separate distinction is needed at the code level — the Applicable To note at M62.4 explicitly includes contracture of tendon sheath. M62.49 covers both muscle and tendon sheath contractures when they occur at multiple sites.
06What documentation distinguishes contracture from muscle spasm for coding purposes?
Contracture implies a fixed or semi-fixed structural shortening — document passive ROM deficits with goniometric values and clinical findings of fibrosis or permanent shortening. Muscle spasm is transient and neurologically mediated; use R25.2 if the note describes intermittent involuntary contraction without fixed structural change.
07Can M62.49 be used as a secondary code?
Yes. M62.49 is frequently listed as a secondary diagnosis alongside primary codes for stroke (I69.–), spinal cord injury (S-codes with sequela 7th character S), cerebral palsy (G80.–), or burn sequelae (T-codes) when multi-site contractures are a documented complication of those conditions.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

  1. 01CDC ICD-10-CM Tabular List 2026 (effective October 1, 2025)
  2. 02
    icd10data.com
    https://www.icd10data.com/ICD10CM/Codes/M00-M99/M60-M63/M62-/M62.49
  3. 03
    icd10data.com
    https://www.icd10data.com/ICD10CM/Codes/M00-M99/M60-M63/M62-/M62.4
  4. 04
    cms.gov
    https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57478&ver=37

Mira AI Scribe

Mira AI Scribe captures the passive ROM deficit measurements, the specific muscle groups involved at each site, the underlying etiology, and any prior conservative care attempts — all from the encounter note. This prevents the vague 'muscle tightness' language that triggers down-coding to unspecified soft tissue disorder codes and flags on medical necessity review.

See how Mira captures M62.49 documentation

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