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ICD-10 Guide
ICD-10 CodesM87.012

M87.012

Billable

Idiopathic aseptic necrosis of left shoulder

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M87.012 is a billable code used to indicate a diagnosis of idiopathic aseptic necrosis of left shoulder.

Key Diagnostic Point:

Idiopathic aseptic necrosis of the left shoulder, also known as osteonecrosis, is a condition characterized by the death of bone tissue due to a lack of blood supply. This condition can occur without any identifiable cause, hence the term 'idiopathic.' The left shoulder is specifically affected, leading to pain, limited range of motion, and potential joint dysfunction. The necrosis typically occurs in the humeral head, which is the ball part of the shoulder joint. Patients may experience symptoms such as shoulder pain that worsens with activity, stiffness, and swelling. Diagnosis is often confirmed through imaging studies such as MRI or X-rays, which can reveal changes in bone density and structure. Treatment options may include conservative management with pain relief and physical therapy, or surgical interventions such as core decompression or joint replacement in more severe cases. The condition is often associated with risk factors such as corticosteroid use, alcohol consumption, and certain medical conditions like lupus or sickle cell disease.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between idiopathic and secondary causes of osteonecrosis.
  • Need for precise documentation of symptoms and imaging findings.
  • Potential overlap with other orthopedic conditions.
  • Variability in treatment approaches and their documentation.

Audit Risk Factors

  • Inadequate documentation of the idiopathic nature of the condition.
  • Failure to document imaging results that support the diagnosis.
  • Misclassification of the condition as a different type of osteonecrosis.
  • Lack of clarity in treatment plans and follow-up care.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes including patient history, physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with shoulder pain, limited range of motion, and imaging findings suggestive of osteonecrosis.

Billing Considerations

Ensure that the idiopathic nature is clearly documented to avoid confusion with secondary causes.

Radiology

Documentation Requirements

Comprehensive imaging reports that detail findings consistent with osteonecrosis.

Common Clinical Scenarios

Imaging studies performed for patients with shoulder pain to rule out osteonecrosis.

Billing Considerations

Clear communication of findings to referring physicians to support accurate coding.

Coding Guidelines

Inclusion Criteria

Use M87.012 When
  • According to ICD
  • 10 coding guidelines, M87
  • 012 should be used when the condition is confirmed as idiopathic and not due to other identifiable causes
  • Documentation must support the diagnosis and include details of the patient's clinical presentation and any imaging studies performed

Exclusion Criteria

Do NOT use M87.012 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopy, shoulder, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when assessing the shoulder joint for osteonecrosis.

Documentation Requirements

Document indications for the procedure and findings.

Specialty Considerations

Orthopedic surgeons should ensure that the diagnosis aligns with the procedure performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like idiopathic aseptic necrosis, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like idiopathic aseptic necrosis, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common symptoms of idiopathic aseptic necrosis?

Common symptoms include shoulder pain, stiffness, and limited range of motion, often worsening with activity.

How is idiopathic aseptic necrosis diagnosed?

Diagnosis is typically made through imaging studies such as MRI or X-rays that reveal changes in the bone structure.

What treatment options are available for this condition?

Treatment may include conservative management with pain relief and physical therapy, or surgical options like core decompression or joint replacement.