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ICD-10 Guide
ICD-10 CodesM87.19

M87.19

Billable

Osteonecrosis due to drugs, multiple sites

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

Code Description

ICD-10 M87.19 is a billable code used to indicate a diagnosis of osteonecrosis due to drugs, multiple sites.

Key Diagnostic Point:

Osteonecrosis due to drugs, particularly corticosteroids and bisphosphonates, is a condition characterized by the death of bone tissue due to a lack of blood supply, often affecting multiple sites in the body. This condition can lead to severe pain, joint dysfunction, and potential collapse of the affected bones. The pathophysiology involves the disruption of blood flow to the bone, which can be exacerbated by the use of certain medications that interfere with bone metabolism. Patients may present with symptoms such as localized pain, swelling, and reduced range of motion in the affected joints. Diagnosis typically involves imaging studies such as MRI or X-rays, which can reveal changes in bone density and structure. Treatment options may include medication adjustments, physical therapy, or surgical interventions such as core decompression or joint replacement, depending on the severity and location of the osteonecrosis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of drugs that can cause osteonecrosis
  • Need for precise documentation of drug history
  • Differentiation from other bone conditions like osteomyelitis
  • Multiple sites of involvement complicating coding

Audit Risk Factors

  • Inadequate documentation of drug history
  • Failure to specify multiple sites affected
  • Misclassification with osteomyelitis or other bone disorders
  • Lack of imaging studies to support diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with joint pain and a history of corticosteroid use.

Billing Considerations

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

Rheumatology

Documentation Requirements

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

Common Clinical Scenarios

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

Billing Considerations

Rheumatologists should note the relationship between systemic disease management and the risk of osteonecrosis.

Coding Guidelines

Inclusion Criteria

Use M87.19 When
  • According to ICD
  • 10 guidelines, M87
  • 19 should be used when osteonecrosis is specifically attributed to drug use and affects multiple sites
  • Coders must ensure that the documentation supports the diagnosis and that the drug
  • related cause is clearly stated

Exclusion Criteria

Do NOT use M87.19 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 joint involved and the reason for the procedure.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is justified based on the patient's symptoms.

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 this condition. M87.19 provides a clear indication of drug-related osteonecrosis, which aids in treatment planning and research.

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 this condition. M87.19 provides a clear indication of drug-related osteonecrosis, which aids in treatment planning and research.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of osteonecrosis, improving the ability to track and manage this condition. M87.19 provides a clear indication of drug-related osteonecrosis, which aids in treatment planning and research.

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 osteonecrosis?

Corticosteroids and bisphosphonates are the most commonly associated medications, but other drugs such as certain chemotherapy agents can also contribute.