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ICD-10 Guide
ICD-10 CodesM87.029

M87.029

Billable

Idiopathic aseptic necrosis of unspecified humerus

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

Code Description

ICD-10 M87.029 is a billable code used to indicate a diagnosis of idiopathic aseptic necrosis of unspecified humerus.

Key Diagnostic Point:

Idiopathic aseptic necrosis of the humerus is a condition characterized by the death of bone tissue due to a lack of blood supply, without the presence of infection. This condition can lead to significant pain, limited range of motion, and potential joint dysfunction. The etiology remains unknown, hence the term 'idiopathic.' It is often associated with risk factors such as corticosteroid use, alcohol consumption, and certain medical conditions like sickle cell disease or systemic lupus erythematosus. Patients may present with symptoms such as shoulder pain, swelling, and difficulty in performing daily activities. Diagnosis typically involves imaging studies, including X-rays and MRI, to assess the extent of necrosis and rule out other conditions such as osteomyelitis or fractures. Treatment options may vary from conservative management, including physical therapy and pain relief, to surgical interventions like core decompression or joint replacement in advanced cases. The prognosis depends on the stage of the disease at diagnosis and the effectiveness of the chosen treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of clear etiology complicates diagnosis.
  • Differentiation from osteomyelitis and other bone infections is necessary.
  • Requires comprehensive documentation of symptoms and imaging results.
  • Potential for misclassification with other forms of osteonecrosis.

Audit Risk Factors

  • Inadequate documentation of symptoms and imaging findings.
  • Failure to differentiate from osteomyelitis.
  • Incorrect coding of laterality.
  • Lack of clarity on treatment plans.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, treatment plans, and patient history.

Common Clinical Scenarios

Patients presenting with shoulder pain and limited mobility, requiring imaging and potential surgical intervention.

Billing Considerations

Ensure clear documentation of the absence of infection and the idiopathic nature of the condition.

Rheumatology

Documentation Requirements

Comprehensive patient history including risk factors, comorbidities, and response to treatments.

Common Clinical Scenarios

Patients with systemic diseases presenting with joint pain and suspected necrosis.

Billing Considerations

Document any underlying conditions that may contribute to the necrosis.

Coding Guidelines

Inclusion Criteria

Use M87.029 When
  • According to ICD
  • 10 guidelines, M87
  • 029 should be used when the necrosis is confirmed as idiopathic and not due to any infectious process
  • Coders must ensure that the documentation supports the diagnosis and that there is no evidence of osteomyelitis or other bone infections

Exclusion Criteria

Do NOT use M87.029 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 conditions related to necrosis.

Documentation Requirements

Document indications for the procedure and findings.

Specialty Considerations

Orthopedic documentation should include pre-operative assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like idiopathic aseptic necrosis, improving data accuracy and facilitating better patient management. The specificity of M87.029 helps in tracking the incidence and outcomes of this condition more effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like idiopathic aseptic necrosis, improving data accuracy and facilitating better patient management. The specificity of M87.029 helps in tracking the incidence and outcomes of this condition more effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like idiopathic aseptic necrosis, improving data accuracy and facilitating better patient management. The specificity of M87.029 helps in tracking the incidence and outcomes of this condition more effectively.

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 idiopathic aseptic necrosis?

The primary cause is unknown, but it is often associated with risk factors such as corticosteroid use, alcohol consumption, and certain medical conditions.

How is idiopathic aseptic necrosis diagnosed?

Diagnosis is typically made through imaging studies like X-rays and MRI, which reveal changes in the bone indicative of necrosis.

What are the treatment options for this condition?

Treatment options range from conservative management, including physical therapy and pain relief, to surgical interventions like core decompression or joint replacement.