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ICD-10 Guide
ICD-10 CodesM87.243

M87.243

Billable

Osteonecrosis due to previous trauma, unspecified hand

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

Code Description

ICD-10 M87.243 is a billable code used to indicate a diagnosis of osteonecrosis due to previous trauma, unspecified hand.

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 M87.243, the osteonecrosis is specifically attributed to previous trauma, which may include fractures, dislocations, or other injuries that compromise the vascular supply to the bone. The unspecified hand designation indicates that the specific location within the hand is not detailed, which can complicate treatment and management. Symptoms often include pain, limited range of motion, and swelling in the affected area. 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, depending on the severity of the condition. Understanding the underlying cause of osteonecrosis is crucial for effective management and prevention of further complications, such as osteomyelitis or chronic pain syndromes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified location can lead to ambiguity in treatment and coding.
  • Requires knowledge of previous trauma history for accurate coding.
  • Differentiating from other bone conditions like osteomyelitis.
  • Potential for multiple codes if other conditions are present.

Audit Risk Factors

  • Insufficient documentation linking trauma to osteonecrosis.
  • Inconsistent coding of unspecified versus specified conditions.
  • Failure to document the severity of the condition.
  • Lack of imaging studies in the medical record.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Post-traumatic osteonecrosis following wrist fractures or dislocations.

Billing Considerations

Ensure clear documentation of the mechanism of injury 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 progress and response to therapy to support ongoing treatment needs.

Coding Guidelines

Inclusion Criteria

Use M87.243 When
  • According to ICD
  • 10 guidelines, M87
  • 243 should be used when osteonecrosis is directly linked to prior trauma without specifying the exact location
  • Coders must ensure that the documentation supports the diagnosis and that other potential causes of osteonecrosis are ruled out

Exclusion Criteria

Do NOT use M87.243 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 osteonecrosis cases.

Documentation Requirements

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

Specialty Considerations

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

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. M87.243 provides a clear designation for osteonecrosis due to trauma, facilitating better treatment planning and outcomes.

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. M87.243 provides a clear designation for osteonecrosis due to trauma, facilitating better treatment planning and outcomes.

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. M87.243 provides a clear designation for osteonecrosis due to trauma, facilitating better treatment planning and 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 M87.243?

The primary cause of osteonecrosis in this code is previous trauma that disrupts blood supply to the bone, leading to tissue death.