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ICD-10 Guide
ICD-10 CodesM87.09

M87.09

Billable

Idiopathic aseptic necrosis of bone, multiple sites

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

Code Description

ICD-10 M87.09 is a billable code used to indicate a diagnosis of idiopathic aseptic necrosis of bone, multiple sites.

Key Diagnostic Point:

Idiopathic aseptic necrosis of bone, 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 in multiple sites within the body, leading to significant pain and functional impairment. The etiology of idiopathic aseptic necrosis remains unclear, but it is often associated with risk factors such as corticosteroid use, alcohol consumption, and certain medical conditions like sickle cell disease or lupus. Patients typically present with joint pain, limited range of motion, and may experience joint collapse if not treated promptly. Diagnosis is primarily made through imaging studies, including MRI, which can reveal early changes in bone marrow and the presence of necrotic areas. Treatment options vary based on the stage of the disease and may include conservative management, surgical interventions such as core decompression, or joint replacement in advanced cases. The condition poses a risk for complications such as osteomyelitis if secondary infections occur, making accurate coding essential for appropriate management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms across patients
  • Need for comprehensive documentation of risk factors and history
  • Differentiation from other types of osteonecrosis and bone infections
  • Potential for co-morbid conditions that may complicate coding

Audit Risk Factors

  • Inadequate documentation of the idiopathic nature of the condition
  • Failure to document associated risk factors or co-morbidities
  • Misclassification of the condition as osteomyelitis or other infections
  • Lack of imaging results to support diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed history of symptoms, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with joint pain and imaging showing necrotic changes.

Billing Considerations

Ensure documentation reflects the idiopathic nature and multiple sites involved.

Rheumatology

Documentation Requirements

Comprehensive assessment of underlying conditions and risk factors.

Common Clinical Scenarios

Patients with autoimmune diseases presenting with joint pain.

Billing Considerations

Document any relevant systemic conditions that may contribute to osteonecrosis.

Coding Guidelines

Inclusion Criteria

Use M87.09 When
  • According to the official coding guidelines, M87
  • 09 should be used when the necrosis is idiopathic and affects multiple sites
  • Coders must ensure that the diagnosis is supported by clinical documentation and imaging studies

Exclusion Criteria

Do NOT use M87.09 When
  • Exclusion criteria include cases where the necrosis is secondary to trauma or infection

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used for joint pain management in patients with osteonecrosis.

Documentation Requirements

Document the joint involved, reason for aspiration/injection, and any imaging results.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is justified based on clinical findings.

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 M87.09, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M87.09, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like M87.09, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of outcomes and resource allocation.

Resources

Clinical References

  • •
    American Academy of Orthopaedic Surgeons (AAOS)

Coding & Billing References

  • •
    American Academy of Orthopaedic Surgeons (AAOS)

Frequently Asked Questions

What are the common causes of idiopathic aseptic necrosis?

Common causes include corticosteroid use, excessive alcohol consumption, and certain medical conditions such as lupus or sickle cell disease. However, in idiopathic cases, the exact cause remains unknown.