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ICD-10 Guide
ICD-10 CodesM87.178

M87.178

Billable

Osteonecrosis due to drugs, left toe(s)

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

Code Description

ICD-10 M87.178 is a billable code used to indicate a diagnosis of osteonecrosis due to drugs, left toe(s).

Key Diagnostic Point:

Osteonecrosis due to drugs, specifically affecting the left toe(s), is a condition characterized by the death of bone tissue due to a lack of blood supply, which can be precipitated by certain medications. This condition often arises from the use of corticosteroids, bisphosphonates, or other drugs that can compromise blood flow to the bones. Patients may present with localized pain, swelling, and limited mobility in the affected toe(s). The diagnosis is typically confirmed through imaging studies such as MRI or X-rays, which can reveal changes in bone density and structure. Osteonecrosis can lead to severe complications, including the risk of fractures and the need for surgical interventions such as joint replacement. It is crucial for healthcare providers to monitor patients on long-term medication regimens for signs of osteonecrosis, especially in high-risk populations, to ensure timely intervention and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires knowledge of drug-related osteonecrosis and its specific coding guidelines.
  • Differentiation from other types of osteonecrosis and related conditions.
  • Documentation must specify the affected site (left toe(s)).
  • Potential for co-morbid conditions that may complicate coding.

Audit Risk Factors

  • Inadequate documentation of drug history leading to misdiagnosis.
  • Failure to specify the affected anatomical site.
  • Lack of imaging studies to support the diagnosis.
  • Inconsistent coding of related conditions or complications.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed patient history, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with pain in the toe(s) after starting corticosteroid therapy.

Billing Considerations

Orthopedic surgeons must document the extent of bone involvement and any surgical interventions planned.

Rheumatology

Documentation Requirements

Comprehensive medication history and assessment of joint involvement.

Common Clinical Scenarios

Patients with autoimmune conditions on long-term immunosuppressive therapy presenting with toe pain.

Billing Considerations

Rheumatologists should monitor for signs of osteonecrosis in patients receiving high-dose corticosteroids.

Coding Guidelines

Inclusion Criteria

Use M87.178 When
  • According to ICD
  • 10 guidelines, M87
  • 178 should be used when osteonecrosis is specifically attributed to drug use and affects the left toe(s)
  • Documentation must clearly indicate the cause and the specific location of the osteonecrosis

Exclusion Criteria

Do NOT use M87.178 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 when a patient with osteonecrosis requires joint aspiration for pain relief.

Documentation Requirements

Document the reason for aspiration and the findings.

Specialty Considerations

Orthopedic specialists should ensure proper coding for joint procedures related to osteonecrosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of osteonecrosis, improving the ability to track and manage drug-related complications. M87.178 provides a clear distinction for osteonecrosis due to drugs, enhancing clinical data accuracy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of osteonecrosis, improving the ability to track and manage drug-related complications. M87.178 provides a clear distinction for osteonecrosis due to drugs, enhancing clinical data accuracy.

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 medications are commonly associated with drug-induced osteonecrosis?

Common medications include corticosteroids, bisphosphonates, and certain chemotherapeutic agents. It is important to document any relevant medication history when coding.