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ICD-10 Guide
ICD-10 CodesM87.229

M87.229

Billable

Osteonecrosis due to previous trauma, unspecified humerus

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

Code Description

ICD-10 M87.229 is a billable code used to indicate a diagnosis of osteonecrosis due to previous trauma, unspecified humerus.

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 M87.229, the osteonecrosis is specifically attributed to previous trauma affecting the humerus, which is the long bone in the upper arm. This condition can arise after fractures, dislocations, or other traumatic injuries that compromise the blood supply to the bone. Symptoms may include pain, limited range of motion, and eventual joint dysfunction. Diagnosis typically involves imaging studies such as X-rays or MRI to assess the extent of bone damage. Treatment options may vary from conservative management, including pain relief and physical therapy, to surgical interventions like core decompression or joint replacement in severe cases. The unspecified nature of the humerus in this code indicates that the specific location of the osteonecrosis within the humerus is not detailed, which can complicate treatment planning and outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified location of osteonecrosis complicates treatment planning.
  • Requires thorough documentation of prior trauma history.
  • Differentiation from other bone conditions like osteomyelitis is necessary.
  • Potential for multiple treatment options increases coding complexity.

Audit Risk Factors

  • Inadequate documentation of prior trauma history.
  • Failure to specify the location of osteonecrosis.
  • Insufficient imaging reports to support diagnosis.
  • Misclassification of osteonecrosis as osteomyelitis.

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed history of trauma, imaging results, and treatment plans.

Common Clinical Scenarios

Post-traumatic osteonecrosis following shoulder dislocation or fracture.

Billing Considerations

Ensure clear documentation of the trauma mechanism and any surgical interventions performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments and rehabilitation plans post-injury.

Common Clinical Scenarios

Rehabilitation following surgical intervention for osteonecrosis.

Billing Considerations

Document patient progress and response to therapy to support ongoing treatment.

Coding Guidelines

Inclusion Criteria

Use M87.229 When
  • According to ICD
  • 10 guidelines, M87
  • 229 should be used when the osteonecrosis is due to previous trauma and the specific location within the humerus is not documented
  • Coders must ensure that the trauma history is well
  • documented and that the diagnosis is supported by imaging findings

Exclusion Criteria

Do NOT use M87.229 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopy, shoulder, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when assessing joint damage in cases of osteonecrosis.

Documentation Requirements

Document indications for arthroscopy and findings.

Specialty Considerations

Orthopedic surgeons should ensure clear linkage between diagnosis and procedure.

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 treatment outcomes and resource allocation. M87.229 reflects the need for detailed documentation of trauma history, which is crucial for appropriate management and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding conditions like osteonecrosis, enabling better tracking of treatment outcomes and resource allocation. M87.229 reflects the need for detailed documentation of trauma history, which is crucial for appropriate management and reimbursement.

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 is the difference between osteonecrosis and osteomyelitis?

Osteonecrosis is the death of bone tissue due to lack of blood supply, while osteomyelitis is an infection of the bone. Accurate diagnosis is essential for appropriate treatment.