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ICD-10 Guide
ICD-10 CodesM87.21

M87.21

Billable

Osteonecrosis due to previous trauma, shoulder

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

Code Description

ICD-10 M87.21 is a billable code used to indicate a diagnosis of osteonecrosis due to previous trauma, shoulder.

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 M87.21, the osteonecrosis is specifically attributed to previous trauma to the shoulder. This condition often arises after fractures, dislocations, or other significant injuries that compromise the blood supply to the bone. The shoulder joint, particularly the humeral head, is susceptible to this condition due to its anatomical structure and the vascular supply it receives. Symptoms typically include pain, limited range of motion, and joint stiffness, which can progressively worsen if not treated. Diagnosis is usually confirmed through imaging studies such as MRI or X-rays, which can reveal changes in bone density and structure. Treatment options may include conservative management with pain relief and physical therapy, or surgical interventions such as core decompression or joint replacement in advanced cases. 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 the relationship between trauma and osteonecrosis.
  • Differentiation from other types of osteonecrosis.
  • Need for precise documentation of prior trauma.
  • Potential for co-morbid conditions affecting bone health.

Audit Risk Factors

  • Inadequate documentation of prior trauma.
  • Failure to specify the location of osteonecrosis.
  • 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 shoulder pain post-fracture or dislocation.

Billing Considerations

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

Radiology

Documentation Requirements

Imaging reports indicating changes in bone structure and blood supply.

Common Clinical Scenarios

Imaging studies performed to assess for osteonecrosis following trauma.

Billing Considerations

Accurate interpretation of imaging findings is crucial for diagnosis.

Coding Guidelines

Inclusion Criteria

Use M87.21 When
  • According to ICD
  • 10 guidelines, M87
  • 21 should be used when osteonecrosis is specifically due to previous trauma
  • It is important to document the type of trauma and any relevant medical history
  • traumatic causes

Exclusion Criteria

Do NOT use M87.21 When
  • Exclusion criteria include cases where osteonecrosis is due to non

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopy, shoulder, diagnostic

Clinical Scenario

Used when assessing joint damage in suspected osteonecrosis.

Documentation Requirements

Document indications for arthroscopy and findings.

Specialty Considerations

Orthopedic surgeons should ensure thorough documentation of the 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 diagnoses and treatment tracking. M87.21 provides a clear link between trauma and the condition, which is essential for appropriate management and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of osteonecrosis, improving the accuracy of diagnoses and treatment tracking. M87.21 provides a clear link between trauma and the condition, which is essential for appropriate management and reimbursement.

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 primary cause of osteonecrosis in M87.21?

The primary cause of osteonecrosis in M87.21 is previous trauma to the shoulder, which disrupts blood flow to the bone.