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ICD-10 Guide
ICD-10 CodesM87.164

M87.164

Billable

Osteonecrosis due to drugs, right fibula

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

Code Description

ICD-10 M87.164 is a billable code used to indicate a diagnosis of osteonecrosis due to drugs, right 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 M87.164, the osteonecrosis is specifically attributed to drug use, which can include corticosteroids, bisphosphonates, and other medications that may compromise blood flow to the bone. The right fibula, a long bone located in the lower leg, is affected in this diagnosis. Patients may present with pain, swelling, and limited mobility in the affected limb. The condition can lead to bone collapse and joint dysfunction if not addressed promptly. Diagnosis typically involves imaging studies such as MRI or X-rays, which can reveal changes in bone density and structure. Treatment options may include medication adjustments, physical therapy, or surgical interventions such as core decompression or joint replacement, depending on the severity of the condition. Understanding the etiology of drug-induced osteonecrosis is crucial for effective management and prevention of further complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between drug-induced osteonecrosis and other types of osteonecrosis.
  • Understanding the specific drugs that can cause osteonecrosis.
  • Documenting the patient's medication history accurately.
  • Identifying the specific bone affected and its implications for treatment.

Audit Risk Factors

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

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the patient's history, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with pain in the lower leg after corticosteroid therapy.

Billing Considerations

Ensure that the specific drug causing the osteonecrosis is documented.

Pharmacology

Documentation Requirements

Comprehensive medication lists and potential side effects.

Common Clinical Scenarios

Patients on long-term corticosteroids for autoimmune conditions.

Billing Considerations

Monitor for signs of osteonecrosis in patients receiving high-risk medications.

Coding Guidelines

Inclusion Criteria

Use M87.164 When
  • According to ICD
  • 10 guidelines, M87
  • 164 should be used when osteonecrosis is specifically due to drug use and affects the right fibula
  • It is essential to document the specific drug involved and any relevant patient history
  • related causes

Exclusion Criteria

Do NOT use M87.164 When
  • Exclusion criteria include osteonecrosis due to trauma or other non

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 joint involved and the reason for the procedure.

Specialty Considerations

Orthopedic specialists should ensure proper coding for joint injections.

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 osteonecrosis, improving the accuracy of patient records and treatment plans. M87.164 provides a clear indication of the cause and location of the condition, which is essential for effective management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like osteonecrosis, improving the accuracy of patient records and treatment plans. M87.164 provides a clear indication of the cause and location of the condition, which is essential for effective management.

Reimbursement & Billing Impact

reimbursement and to avoid audits.

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 this code?

The primary cause of osteonecrosis in M87.164 is drug use, particularly medications that affect blood flow to the bone.