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ICD-10 Guide
ICD-10 CodesM87.263

M87.263

Billable

Osteonecrosis due to previous trauma, unspecified tibia

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

Code Description

ICD-10 M87.263 is a billable code used to indicate a diagnosis of osteonecrosis due to previous trauma, unspecified tibia.

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 M87.263, the osteonecrosis is specifically attributed to previous trauma affecting the tibia, although the exact location within the tibia is unspecified. This condition can arise from various traumatic events, including fractures, dislocations, or other injuries that compromise the blood supply to the bone. The tibia, being a weight-bearing bone, is particularly susceptible to osteonecrosis, which can lead to significant pain, functional impairment, and potential joint degeneration. Clinically, patients may present with localized pain, swelling, and reduced range of motion in the affected limb. Diagnosis typically involves imaging studies such as X-rays, MRI, or CT scans to assess the extent of bone damage and to rule out other conditions such as osteomyelitis or bone infections. Treatment options may include conservative management, such as pain relief and physical therapy, or surgical interventions like core decompression or joint replacement in advanced cases.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires accurate documentation of prior trauma history.
  • Differentiation from other bone conditions like osteomyelitis.
  • Need for precise imaging results to support diagnosis.
  • Potential for co-morbid conditions affecting treatment and coding.

Audit Risk Factors

  • Insufficient documentation of the traumatic event.
  • Lack of imaging studies to support diagnosis.
  • Inconsistent use of terminology in clinical notes.
  • Failure to document co-existing conditions.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with pain after a tibial fracture or dislocation.

Billing Considerations

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

Radiology

Documentation Requirements

Comprehensive imaging reports detailing findings related to osteonecrosis.

Common Clinical Scenarios

Imaging studies performed to evaluate bone integrity post-trauma.

Billing Considerations

Radiologists should provide clear descriptions of findings to support orthopedic diagnoses.

Coding Guidelines

Inclusion Criteria

Use M87.263 When
  • According to ICD
  • 10 guidelines, M87
  • 263 should be used when there is a confirmed diagnosis of osteonecrosis due to prior trauma without specification of the affected area of the tibia
  • Coders must ensure that the documentation supports the diagnosis and that the trauma history is clearly outlined

Exclusion Criteria

Do NOT use M87.263 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 any imaging findings.

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 greater specificity in coding osteonecrosis, enabling better tracking of the condition and its treatment outcomes. M87.263 provides a clear framework for coding osteonecrosis due to trauma, which can enhance data accuracy and improve patient care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding osteonecrosis, enabling better tracking of the condition and its treatment outcomes. M87.263 provides a clear framework for coding osteonecrosis due to trauma, which can enhance data accuracy and improve patient care.

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 a lack of blood supply, while osteomyelitis is an infection of the bone. Accurate diagnosis is crucial for appropriate coding and treatment.