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ICD-10 Guide
ICD-10 CodesM87.05

M87.05

Billable

Idiopathic aseptic necrosis of pelvis and femur

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

Code Description

ICD-10 M87.05 is a billable code used to indicate a diagnosis of idiopathic aseptic necrosis of pelvis and femur.

Key Diagnostic Point:

Idiopathic aseptic necrosis of the pelvis and femur is a condition characterized by the death of bone tissue due to a lack of blood supply, without the presence of infection. This condition often affects the femoral head and can lead to significant pain, limited mobility, and potential joint dysfunction. The etiology remains unclear, hence the term 'idiopathic.' Risk factors may include corticosteroid use, excessive alcohol consumption, and certain medical conditions such as sickle cell disease or lupus. Patients typically present with hip pain that may radiate to the groin or thigh, and symptoms can worsen with weight-bearing activities. Diagnosis is primarily through imaging studies, including X-rays and MRI, which can reveal changes in bone density and structure. Early intervention is crucial to prevent further joint damage and may involve conservative management or surgical options, depending on the severity of the necrosis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between idiopathic and secondary causes of osteonecrosis.
  • Understanding the nuances of aseptic versus septic conditions.
  • The need for precise documentation of symptoms and imaging findings.
  • Potential overlap with other orthopedic codes related to hip disorders.

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 osteomyelitis or other infections.
  • Inconsistent coding of associated symptoms or complications.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, treatment plans, and follow-up notes.

Common Clinical Scenarios

Patients presenting with hip pain, limited range of motion, and imaging findings suggestive of necrosis.

Billing Considerations

Ensure that the documentation clearly states the idiopathic nature and any risk factors present.

Radiology

Documentation Requirements

Comprehensive imaging reports detailing findings related to necrosis.

Common Clinical Scenarios

Imaging studies performed for patients with hip pain to assess for necrosis.

Billing Considerations

Radiologists should provide clear descriptions of findings to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use M87.05 When
  • According to ICD
  • 10 guidelines, M87
  • 05 should be used when the necrosis is confirmed to be idiopathic and not due to other underlying conditions
  • Documentation must support the diagnosis, including imaging results and clinical findings

Exclusion Criteria

Do NOT use M87.05 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27130CPT Code

Total hip arthroplasty

Clinical Scenario

Used in cases of severe necrosis requiring joint replacement.

Documentation Requirements

Operative reports and pre-operative evaluations.

Specialty Considerations

Orthopedic surgeons must document the extent of necrosis and rationale for surgery.

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 M87.05, improving the accuracy of data collection and reimbursement processes. It emphasizes the need for detailed documentation to support the diagnosis.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M87.05, improving the accuracy of data collection and reimbursement processes. It emphasizes the need for detailed documentation to support the diagnosis.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the need for detailed documentation to support the diagnosis.

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 hip pain, limited range of motion, and pain that worsens with weight-bearing activities.

How is idiopathic aseptic necrosis diagnosed?

Diagnosis typically involves a combination of clinical evaluation, imaging studies such as X-rays or MRI, and ruling out other conditions.

What treatment options are available for M87.05?

Treatment may include conservative management with physical therapy and pain relief, or surgical options such as hip arthroplasty in severe cases.