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ICD-10 Guide
ICD-10 CodesM87.12

M87.12

Billable

Osteonecrosis due to drugs, humerus

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

Code Description

ICD-10 M87.12 is a billable code used to indicate a diagnosis of osteonecrosis due to drugs, humerus.

Key Diagnostic Point:

Osteonecrosis due to drugs, specifically affecting the humerus, is a condition characterized by the death of bone tissue due to a lack of blood supply, often as a result of pharmacological agents. This condition can arise from the use of corticosteroids, bisphosphonates, or other medications that may compromise blood flow to the bone. Patients may present with pain in the shoulder region, limited range of motion, and potential joint dysfunction. The humerus, being a critical bone in the shoulder girdle, is particularly susceptible to osteonecrosis, leading to significant orthopedic complications such as joint instability and arthritis. Diagnosis typically involves imaging studies such as MRI or X-rays, which can reveal changes in bone density and structure. Early detection is crucial to prevent further deterioration and to manage symptoms effectively. Treatment options may include medication adjustments, physical therapy, or surgical interventions such as joint replacement in severe cases.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires knowledge of drug-induced conditions
  • Differentiation from other types of osteonecrosis
  • Need for precise documentation of drug history
  • Potential overlap with other orthopedic codes

Audit Risk Factors

  • Inadequate documentation of drug history
  • Failure to specify the affected bone
  • Misclassification with other osteonecrosis codes
  • Lack of imaging documentation

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed history of medication use, imaging results, and clinical findings.

Common Clinical Scenarios

Patients presenting with shoulder pain and a history of corticosteroid use.

Billing Considerations

Ensure that the documentation clearly links the drug use to the osteonecrosis diagnosis.

Rheumatology

Documentation Requirements

Comprehensive medication history and assessment of joint function.

Common Clinical Scenarios

Patients with autoimmune disorders on long-term steroid therapy developing shoulder pain.

Billing Considerations

Document the rationale for medication use and any changes in therapy.

Coding Guidelines

Inclusion Criteria

Use M87.12 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include details about the drug exposure and the specific anatomical site affected

Exclusion Criteria

Do NOT use M87.12 When
  • Exclude conditions that do not meet the criteria for osteonecrosis due to drugs

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 the patient's response.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is justified based on clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of osteonecrosis, enabling better tracking of drug-related cases and improving patient management strategies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of osteonecrosis, enabling better tracking of drug-related cases and improving patient management strategies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of osteonecrosis, enabling better tracking of drug-related cases and improving patient management strategies.

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 medications are commonly associated with osteonecrosis?

Common medications include corticosteroids, bisphosphonates, and certain chemotherapy agents. It is essential to document any relevant medication history when coding.