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ICD-10 Guide
ICD-10 CodesM87.264

M87.264

Billable

Osteonecrosis due to previous trauma, right fibula

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

Code Description

ICD-10 M87.264 is a billable code used to indicate a diagnosis of osteonecrosis due to previous trauma, 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 M87.264, the osteonecrosis is specifically attributed to previous trauma affecting the right fibula. This condition can arise after fractures, dislocations, or other traumatic injuries that compromise the blood supply to the bone. The right fibula, being a long bone in the lower leg, can suffer from osteonecrosis due to its anatomical position and vascular supply. Symptoms may include pain, swelling, and limited mobility in the affected area. Diagnosis typically involves imaging studies such as X-rays or MRI to assess the extent of bone damage and to rule out other conditions such as osteomyelitis or bone infections. Treatment options may vary from conservative management, including pain relief and physical therapy, to surgical interventions like bone grafting or joint replacement in severe 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 treatment and coding.

Audit Risk Factors

  • Inadequate documentation of prior trauma.
  • Misdiagnosis or confusion with osteomyelitis.
  • Failure to document imaging results.
  • Inconsistent coding of associated conditions.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed history of trauma, imaging results, and treatment plans.

Common Clinical Scenarios

Post-traumatic osteonecrosis following fractures or surgical interventions.

Billing Considerations

Ensure accurate documentation of the mechanism of injury and any surgical history.

Radiology

Documentation Requirements

Clear imaging reports indicating the presence of osteonecrosis and ruling out other conditions.

Common Clinical Scenarios

Imaging studies for patients with suspected osteonecrosis due to trauma.

Billing Considerations

Radiologists should provide detailed descriptions of findings to support coding.

Coding Guidelines

Inclusion Criteria

Use M87.264 When
  • According to ICD
  • 10 guidelines, M87
  • 264 should be used when osteonecrosis is specifically due to previous trauma
  • Coders must ensure that the documentation supports the diagnosis and that the trauma is clearly linked to the osteonecrosis

Exclusion Criteria

Do NOT use M87.264 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 pain management in patients with osteonecrosis.

Documentation Requirements

Document the indication for the procedure and the joint involved.

Specialty Considerations

Orthopedic specialists may perform this procedure for symptomatic relief.

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 diagnosis and treatment tracking. M87.264 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 osteonecrosis, improving the accuracy of diagnosis and treatment tracking. M87.264 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 this code?

The primary cause of osteonecrosis in this code is previous trauma to the right fibula, which disrupts blood supply to the bone.