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ICD-10 Guide
ICD-10 CodesM87.161

M87.161

Billable

Osteonecrosis due to drugs, right tibia

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

Code Description

ICD-10 M87.161 is a billable code used to indicate a diagnosis of osteonecrosis due to drugs, right tibia.

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 M87.161, the osteonecrosis is specifically attributed to drug use, which can include corticosteroids, alcohol, and certain chemotherapy agents. The right tibia is the affected bone, which is crucial for weight-bearing and mobility. Patients may present with symptoms such as pain, swelling, and limited range of motion in the affected limb. The condition can lead to severe complications, including joint collapse and the need for surgical interventions such as joint replacement. Diagnosis typically involves imaging studies like MRI or X-rays, which can reveal changes in bone density and structure. Treatment options may vary from conservative management, including pain relief and physical therapy, to surgical procedures depending on the severity of the necrosis. Understanding the etiology, clinical presentation, and management of osteonecrosis is essential for accurate coding and effective patient care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires knowledge of drug-related osteonecrosis versus other types.
  • Differentiation from similar conditions like osteomyelitis.
  • Need for precise documentation of drug history.
  • Potential for multiple codes if complications arise.

Audit Risk Factors

  • Inadequate documentation of drug history.
  • Failure to specify the affected bone.
  • Misclassification of osteonecrosis as 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 joint pain and a history of corticosteroid use.

Billing Considerations

Documentation must clearly link the drug use to the osteonecrosis.

Rheumatology

Documentation Requirements

Comprehensive medication history and assessment of underlying conditions.

Common Clinical Scenarios

Patients with autoimmune disorders on long-term corticosteroids developing bone pain.

Billing Considerations

Consideration of other risk factors for osteonecrosis, such as systemic diseases.

Coding Guidelines

Inclusion Criteria

Use M87.161 When
  • According to ICD
  • 10 coding guidelines, M87
  • 161 should be used when osteonecrosis is specifically due to drug use and the right tibia is affected
  • Coders must ensure that the documentation supports the diagnosis and that the drug
  • related etiology is clearly stated
  • related causes

Exclusion Criteria

Do NOT use M87.161 When
  • Exclusion criteria include osteonecrosis due to trauma or other non

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 the indication for the procedure and the patient's response.

Specialty Considerations

Orthopedic specialists may perform this procedure for symptomatic relief.

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 osteonecrosis, enabling better tracking of drug-related cases. This specificity aids in research and treatment planning, improving patient outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like osteonecrosis, enabling better tracking of drug-related cases. This specificity aids in research and treatment planning, improving patient outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like osteonecrosis, enabling better tracking of drug-related cases. This specificity aids in research and treatment planning, improving patient outcomes.

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 osteonecrosis in this code?

The primary cause of osteonecrosis in M87.161 is drug use, particularly corticosteroids and other medications that can impair blood flow to the bone.