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ICD-10 Guide
ICD-10 CodesM87.266

M87.266

Billable

Osteonecrosis due to previous trauma, unspecified fibula

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

Code Description

ICD-10 M87.266 is a billable code used to indicate a diagnosis of osteonecrosis due to previous trauma, unspecified fibula.

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 M87.266, the osteonecrosis is specifically attributed to previous trauma affecting the fibula, which is one of the two bones in the lower leg. This condition can arise after fractures, dislocations, or other significant injuries that compromise the blood flow to the bone. Symptoms may include pain, swelling, and limited range of motion in the affected area. Over time, if left untreated, osteonecrosis can lead to joint collapse and severe disability. 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 bone grafting 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.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of trauma history and its impact on bone health.
  • Differentiation from other forms of osteonecrosis and related conditions.
  • Need for precise documentation of previous trauma.
  • Potential for co-morbid conditions affecting the fibula.

Audit Risk Factors

  • Inadequate documentation of trauma history.
  • Failure to specify the fibula as the affected bone.
  • Misclassification of osteonecrosis as osteomyelitis.
  • Lack of imaging studies to support diagnosis.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with pain in the lower leg following trauma, requiring surgical intervention.

Billing Considerations

Ensure clear documentation of the mechanism of injury and any prior treatments.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments and rehabilitation plans post-trauma.

Common Clinical Scenarios

Patients undergoing rehabilitation after surgical intervention for osteonecrosis.

Billing Considerations

Document progress and response to therapy to support ongoing treatment.

Coding Guidelines

Inclusion Criteria

Use M87.266 When
  • Follow official ICD
  • CM guidelines for coding osteonecrosis, ensuring accurate documentation of the cause and affected site
  • Include any relevant history of trauma and associated conditions

Exclusion Criteria

Do NOT use M87.266 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 often perform this procedure.

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 accuracy of data collection and reimbursement processes. M87.266 provides a clear framework for documenting trauma-related osteonecrosis.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of osteonecrosis, improving the accuracy of data collection and reimbursement processes. M87.266 provides a clear framework for documenting trauma-related osteonecrosis.

Reimbursement & Billing Impact

reimbursement processes. M87.266 provides a clear framework for documenting trauma-related osteonecrosis.

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 coded as M87.266?

The primary cause is previous trauma to the fibula, which disrupts blood supply and leads to bone tissue death.