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ICD-10 Guide
ICD-10 CodesM87.021

M87.021

Billable

Idiopathic aseptic necrosis of right humerus

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

Code Description

ICD-10 M87.021 is a billable code used to indicate a diagnosis of idiopathic aseptic necrosis of right humerus.

Key Diagnostic Point:

Idiopathic aseptic necrosis of the right humerus is a condition characterized by the death of bone tissue due to a lack of blood supply, without the presence of infection. This condition can lead to severe pain, limited range of motion, and potential joint dysfunction. The etiology remains unknown, hence the term 'idiopathic.' It is often associated with risk factors such as corticosteroid use, alcohol consumption, and certain medical conditions like sickle cell disease or lupus. Patients may present with symptoms such as shoulder pain, swelling, and difficulty in performing daily activities. Diagnosis typically involves imaging studies, including X-rays and MRI, which can reveal changes in bone density and structure. Treatment options may include conservative management with pain relief, physical therapy, or surgical interventions such as core decompression or joint replacement in advanced cases. Early diagnosis and intervention are crucial to prevent further complications and preserve joint function.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Idiopathic nature complicates the identification of underlying causes.
  • Differentiation from other types of necrosis or osteomyelitis is necessary.
  • Requires thorough documentation of symptoms and imaging results.
  • Potential for co-morbid conditions that may affect coding.

Audit Risk Factors

  • Inadequate documentation of symptoms and treatment plans.
  • Failure to specify the laterality of the condition.
  • Misclassification of osteonecrosis as osteomyelitis.
  • Lack of imaging results in the medical record.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes, imaging reports, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with shoulder pain, limited range of motion, and history of corticosteroid use.

Billing Considerations

Ensure accurate laterality is documented and consider potential surgical interventions.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments and rehabilitation plans should be included.

Common Clinical Scenarios

Patients undergoing rehabilitation post-surgery for necrosis.

Billing Considerations

Document the impact on daily activities and functional limitations.

Coding Guidelines

Inclusion Criteria

Use M87.021 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's idiopathic nature and laterality

Exclusion Criteria

Do NOT use M87.021 When
  • Exclude conditions that may indicate infection or trauma unless clearly documented

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopy, shoulder, surgical

Clinical Scenario

Used in cases where surgical intervention for necrosis is required.

Documentation Requirements

Operative reports detailing the procedure and findings.

Specialty Considerations

Orthopedic documentation must include pre-operative assessments.

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 M87.021, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of treatment outcomes and epidemiological studies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M87.021, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of treatment outcomes and epidemiological studies.

Reimbursement & Billing Impact

reimbursement processes. It has also facilitated better tracking of treatment outcomes and epidemiological studies.

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 is the primary cause of idiopathic aseptic necrosis?

The primary cause is unknown, but it is often associated with risk factors such as corticosteroid use, alcohol consumption, and certain medical conditions.

How is idiopathic aseptic necrosis diagnosed?

Diagnosis is typically made through imaging studies like X-rays and MRI, which reveal changes in bone structure and density.