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ICD-10 Guide
ICD-10 CodesM87.139

M87.139

Billable

Osteonecrosis due to drugs of unspecified carpus

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

Code Description

ICD-10 M87.139 is a billable code used to indicate a diagnosis of osteonecrosis due to drugs of unspecified carpus.

Key Diagnostic Point:

Osteonecrosis, also known as avascular necrosis, is a condition characterized by the death of bone tissue due to a lack of blood supply. In the case of M87.139, the osteonecrosis is specifically attributed to the use of certain drugs, which can disrupt blood flow to the bones. This condition can occur in various locations within the body, but when it affects the carpal bones, it can lead to significant pain, limited range of motion, and potential joint dysfunction. The carpus, consisting of eight small bones in the wrist, is particularly susceptible to osteonecrosis due to its complex vascular supply. Common drugs associated with this condition include corticosteroids and certain chemotherapy agents. Clinically, patients may present with wrist pain, swelling, and decreased function. Diagnosis typically involves imaging studies such as MRI or X-rays to assess bone integrity and blood flow. Treatment options may include conservative management, such as physical therapy and pain relief, or surgical interventions like core decompression or joint replacement in severe cases. Understanding the etiology and management of drug-induced osteonecrosis is crucial for effective patient care and coding accuracy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of drugs that can cause osteonecrosis complicating documentation.
  • Need for precise identification of the affected carpal bone.
  • Differentiation from other types of osteonecrosis and osteomyelitis.
  • Potential for overlapping diagnoses requiring careful coding.

Audit Risk Factors

  • Inadequate documentation of drug history.
  • Failure to specify the affected carpal bone.
  • Misdiagnosis or confusion with osteomyelitis.
  • Lack of imaging studies to support diagnosis.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed history of drug use, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with wrist pain after corticosteroid therapy.

Billing Considerations

Ensure clear documentation of the relationship between drug use and osteonecrosis.

Rheumatology

Documentation Requirements

Comprehensive medication history and assessment of joint function.

Common Clinical Scenarios

Patients with autoimmune conditions on long-term corticosteroids developing wrist pain.

Billing Considerations

Document the rationale for drug use and monitoring for side effects.

Coding Guidelines

Inclusion Criteria

Use M87.139 When
  • According to ICD
  • 10 guidelines, M87
  • 139 should be used when osteonecrosis is confirmed to be drug
  • induced and the specific carpal bone is not identified
  • Coders must ensure that the documentation supports the diagnosis and that other potential causes of osteonecrosis are ruled out

Exclusion Criteria

Do NOT use M87.139 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

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

Clinical Scenario

Used for pain management in patients with osteonecrosis.

Documentation Requirements

Document indication for the procedure and any imaging performed.

Specialty Considerations

Orthopedic specialists should ensure clear documentation of the joint involved.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding conditions like osteonecrosis, enabling better tracking of drug-related complications. M87.139 provides a clear framework for identifying cases of drug-induced osteonecrosis, which can improve patient management and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding conditions like osteonecrosis, enabling better tracking of drug-related complications. M87.139 provides a clear framework for identifying cases of drug-induced osteonecrosis, which can improve patient management and outcomes.

Reimbursement & Billing Impact

reimbursement.

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 types of drugs can cause osteonecrosis?

Corticosteroids, certain chemotherapy agents, and bisphosphonates are commonly associated with osteonecrosis.

How is osteonecrosis diagnosed?

Diagnosis typically involves a combination of patient history, physical examination, and imaging studies such as MRI or X-rays.

What are the treatment options for osteonecrosis?

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