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ICD-10 Guide
ICD-10 CodesM87.278

M87.278

Billable

Osteonecrosis due to previous trauma, left toe(s)

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

Code Description

ICD-10 M87.278 is a billable code used to indicate a diagnosis of osteonecrosis due to previous trauma, left toe(s).

Key Diagnostic Point:

Osteonecrosis, also known as avascular necrosis, occurs when blood supply to a bone is disrupted, leading to bone death. In the case of M87.278, the osteonecrosis is specifically attributed to previous trauma affecting the left toe(s). This condition can arise from various traumatic events, such as fractures, dislocations, or severe contusions that compromise the vascular supply to the bone. Clinically, patients may present with localized pain, swelling, and limited range of motion in the affected toe(s). Over time, if left untreated, osteonecrosis can lead to joint collapse and significant functional impairment. Diagnosis typically involves imaging studies, such as X-rays or MRI, to assess the extent of bone damage and to rule out other conditions like osteomyelitis, which is an infection of the bone that can mimic osteonecrosis symptoms. Treatment options may include conservative management, such as rest and analgesics, or surgical interventions like core decompression or joint replacement, depending on the severity of the condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires precise documentation of prior trauma history.
  • Differentiation from other conditions like osteomyelitis.
  • Need for accurate imaging reports to support diagnosis.
  • Potential for multiple codes if co-existing conditions are present.

Audit Risk Factors

  • Inadequate documentation of trauma history.
  • Failure to provide imaging results.
  • Misclassification of osteonecrosis as osteomyelitis.
  • Lack of detail regarding the affected anatomical site.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with pain in the toe following an injury, requiring surgical intervention.

Billing Considerations

Ensure that the documentation clearly states the relationship between trauma and osteonecrosis.

Radiology

Documentation Requirements

Comprehensive imaging reports that detail findings consistent with osteonecrosis.

Common Clinical Scenarios

Imaging studies performed to evaluate suspected osteonecrosis after trauma.

Billing Considerations

Radiologists should include specific notes on the vascular status of the bone.

Coding Guidelines

Inclusion Criteria

Use M87.278 When
  • According to ICD
  • 10 guidelines, M87
  • 278 should be used when osteonecrosis is directly linked to prior trauma
  • Coders must ensure that the documentation supports the diagnosis and that the specific site is clearly indicated

Exclusion Criteria

Do NOT use M87.278 When
  • Exclusion criteria include conditions that do not relate to trauma

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

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

Clinical Scenario

Used when joint aspiration is performed to relieve pain associated with osteonecrosis.

Documentation Requirements

Document the indication for the procedure and the findings.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is linked 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 diagnosis and treatment tracking. M87.278 provides specificity regarding the affected site, which was less detailed in ICD-9.

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. M87.278 provides specificity regarding the affected site, which was less detailed in ICD-9.

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 that disrupts blood supply to the affected bone, leading to bone death.