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ICD-10 Guide
ICD-10 CodesM87.18

M87.18

Billable

Osteonecrosis due to drugs, other site

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

Code Description

ICD-10 M87.18 is a billable code used to indicate a diagnosis of osteonecrosis due to drugs, other site.

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. This specific code, M87.18, refers to osteonecrosis that occurs as a result of drug use, affecting sites other than the hip or knee. Commonly implicated drugs include corticosteroids and bisphosphonates, which can disrupt the normal blood flow to bones. Patients may present with pain, swelling, and limited range of motion in the affected area. 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 more invasive procedures depending on the severity of the condition. Understanding the implications of drug-induced osteonecrosis is crucial for effective management and coding, as it can significantly impact patient outcomes and healthcare costs.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of drugs that can cause osteonecrosis
  • Differentiation from other types of osteonecrosis
  • Need for precise documentation of drug history
  • Potential for multiple affected sites

Audit Risk Factors

  • Inadequate documentation of drug history
  • Failure to specify the site of osteonecrosis
  • Misclassification of osteonecrosis as osteomyelitis
  • Lack of imaging studies to support diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed history of medication use, imaging results, and clinical findings.

Common Clinical Scenarios

Patients presenting with joint pain after corticosteroid therapy or bisphosphonate treatment.

Billing Considerations

Orthopedic surgeons should ensure that the site of osteonecrosis is clearly documented to avoid coding errors.

Rheumatology

Documentation Requirements

Comprehensive medication history, including duration and dosage of drugs that may contribute to osteonecrosis.

Common Clinical Scenarios

Patients with autoimmune diseases on long-term corticosteroids presenting with joint symptoms.

Billing Considerations

Rheumatologists should be aware of the potential for drug-induced osteonecrosis in patients receiving immunosuppressive therapy.

Coding Guidelines

Inclusion Criteria

Use M87.18 When
  • According to ICD
  • 10 guidelines, M87
  • 18 should be used when osteonecrosis is specifically attributed to drug use and affects sites other than the hip or knee
  • Coders must ensure that the documentation supports the diagnosis and includes details about the drugs involved

Exclusion Criteria

Do NOT use M87.18 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 the indication for the procedure and the joint involved.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is linked to the diagnosis of 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. M87.18 provides a clear distinction for osteonecrosis due to drugs, enhancing data accuracy and patient care.

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. M87.18 provides a clear distinction for osteonecrosis due to drugs, enhancing data accuracy and patient care.

Reimbursement & Billing Impact

reimbursement and to avoid denials.

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?

Common drugs associated with osteonecrosis include corticosteroids, bisphosphonates, and certain chemotherapy agents. It is important to document the specific medications and dosages used by the patient.