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ICD-10 Guide
ICD-10 CodesM87.22

M87.22

Billable

Osteonecrosis due to previous trauma, humerus

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

Code Description

ICD-10 M87.22 is a billable code used to indicate a diagnosis of osteonecrosis due to previous trauma, humerus.

Key Diagnostic Point:

Osteonecrosis of the humerus is a condition characterized by the death of bone tissue due to a lack of blood supply, often following trauma such as fractures or dislocations. This condition can lead to severe pain, limited range of motion, and eventual joint dysfunction. The humerus, being a long bone in the upper arm, is particularly susceptible to osteonecrosis when trauma disrupts its vascular supply. The pathophysiology involves the interruption of blood flow, leading to ischemia and subsequent necrosis of the bone. Patients may present with symptoms such as shoulder pain, swelling, and decreased mobility. Diagnosis typically involves imaging studies, including X-rays and MRI, 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 causes and appropriate management strategies is crucial for optimizing patient outcomes.

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 and bone conditions.
  • Need for precise documentation of prior trauma.
  • Potential for co-morbid conditions affecting coding.

Audit Risk Factors

  • Inadequate documentation of prior trauma.
  • Failure to specify the location of osteonecrosis.
  • Misclassification with other osteonecrosis codes.
  • 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 those with chronic pain after dislocation.

Billing Considerations

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

Radiology

Documentation Requirements

Clear imaging reports indicating signs of osteonecrosis and any relevant findings.

Common Clinical Scenarios

Imaging studies performed for patients with shoulder pain or history of trauma.

Billing Considerations

Accurate interpretation of imaging findings is crucial for proper coding.

Coding Guidelines

Inclusion Criteria

Use M87.22 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the cause (previous trauma) and location (humerus) of osteonecrosis

Exclusion Criteria

Do NOT use M87.22 When
  • Exclude conditions that do not relate to trauma

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopy, shoulder, surgical

Clinical Scenario

Used for surgical intervention in cases of osteonecrosis.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic documentation must clearly link the procedure to the diagnosis.

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 data collection and reimbursement processes. M87.22 provides a clear link to trauma, which is essential for treatment planning and outcomes tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of osteonecrosis, improving the accuracy of data collection and reimbursement processes. M87.22 provides a clear link to trauma, which is essential for treatment planning and outcomes tracking.

Reimbursement & Billing Impact

reimbursement processes. M87.22 provides a clear link to trauma, which is essential for treatment planning and outcomes tracking.

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 M87.22?

The primary cause is previous trauma to the humerus, which disrupts blood supply and leads to bone tissue death.