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ICD-10 Guide
ICD-10 CodesM87.211

M87.211

Billable

Osteonecrosis due to previous trauma, right shoulder

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

Code Description

ICD-10 M87.211 is a billable code used to indicate a diagnosis of osteonecrosis due to previous trauma, right 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 M87.211, the osteonecrosis is specifically attributed to previous trauma to the right shoulder. This condition often arises after a fracture or dislocation that disrupts the blood supply to the bone. The right shoulder, being a complex joint, can be particularly susceptible to such injuries, leading to pain, limited range of motion, and potential joint collapse if not addressed. Clinically, patients may present with symptoms such as shoulder pain that worsens with activity, stiffness, and swelling. Diagnosis typically involves imaging studies, including X-rays and MRI, to assess the extent of bone damage and to rule out other conditions such as osteomyelitis or arthritis. 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 bone conditions like osteomyelitis.
  • Need for precise documentation of prior trauma.
  • Potential for co-morbid conditions affecting the shoulder.

Audit Risk Factors

  • Inadequate documentation of prior trauma.
  • Failure to specify the affected shoulder.
  • Misdiagnosis or coding of related conditions.
  • 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-injury, 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-injury.

Common Clinical Scenarios

Patients undergoing rehabilitation after surgical treatment for osteonecrosis.

Billing Considerations

Document progress and response to therapy to support ongoing treatment.

Coding Guidelines

Inclusion Criteria

Use M87.211 When
  • According to ICD
  • 10 guidelines, M87
  • 211 should be used when osteonecrosis is directly linked to previous trauma
  • Coders must ensure that the documentation supports the diagnosis and that the right shoulder is specified
  • induced osteonecrosis

Exclusion Criteria

Do NOT use M87.211 When
  • Exclusion criteria include conditions that do not relate to trauma

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopy, shoulder, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when assessing joint damage in suspected osteonecrosis.

Documentation Requirements

Document indications for arthroscopy and findings.

Specialty Considerations

Orthopedic surgeons should ensure detailed operative notes.

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 data accuracy and treatment tracking. M87.211 provides a clear link between trauma and the resulting 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 conditions like osteonecrosis, improving data accuracy and treatment tracking. M87.211 provides a clear link between trauma and the resulting 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 M87.211?

The primary cause is previous trauma that disrupts blood supply to the bone, leading to tissue death.

How can osteonecrosis be differentiated from osteomyelitis?

Osteonecrosis is primarily due to lack of blood supply, while osteomyelitis is an infection of the bone. Imaging and clinical history are key in differentiation.