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ICD-10 Guide
ICD-10 CodesM87.25

M87.25

Billable

Osteonecrosis due to previous trauma, pelvis and femur

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

Code Description

ICD-10 M87.25 is a billable code used to indicate a diagnosis of osteonecrosis due to previous trauma, pelvis and femur.

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 M87.25, the osteonecrosis is specifically attributed to previous trauma affecting the pelvis and femur. This condition often arises after fractures, dislocations, or other significant injuries that compromise the blood supply to the bone. The pelvis and femur are critical weight-bearing structures, and osteonecrosis in these areas can lead to severe pain, limited mobility, and potential joint collapse. Clinically, patients may present with hip pain, groin pain, or referred pain to the knee, often exacerbated by weight-bearing activities. Diagnosis typically involves imaging studies such as MRI or X-rays, which can reveal changes in bone density and structure. Treatment options may include conservative management, such as pain relief and physical therapy, or surgical interventions like core decompression or joint replacement, depending on the severity of the condition and the extent of bone involvement.

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 not related to trauma.
  • Need for precise documentation of prior trauma history.
  • Potential for co-morbid conditions affecting bone health.

Audit Risk Factors

  • Inadequate documentation of prior trauma.
  • Failure to specify the affected bone(s).
  • Misclassification of osteonecrosis due to other causes.
  • 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 hip pain following a fracture or dislocation.

Billing Considerations

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

Radiology

Documentation Requirements

Clear imaging reports indicating the presence of osteonecrosis and its location.

Common Clinical Scenarios

Imaging studies performed for patients with suspected osteonecrosis.

Billing Considerations

Radiologists should provide detailed descriptions of findings to support coding.

Coding Guidelines

Inclusion Criteria

Use M87.25 When
  • According to ICD
  • 10 coding guidelines, M87
  • 25 should be used when there is clear documentation linking osteonecrosis to previous trauma
  • It is important to ensure that the diagnosis is supported by imaging findings and that the specific bones affected are documented

Exclusion Criteria

Do NOT use M87.25 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used for joint pain management in patients with osteonecrosis.

Documentation Requirements

Document the indication for the procedure and any imaging findings.

Specialty Considerations

Orthopedic specialists should ensure clear linkage between the procedure and 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, including the ability to specify the cause as trauma. This specificity aids in better tracking of the condition and its treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of osteonecrosis, including the ability to specify the cause as trauma. This specificity aids in better tracking of the condition and its treatment outcomes.

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 M87.25?

The primary cause of osteonecrosis in M87.25 is previous trauma that disrupts the blood supply to the affected bone, leading to bone cell death.