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ICD-10 Guide
ICD-10 CodesM87.31

M87.31

Billable

Other secondary osteonecrosis, shoulder

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

Code Description

ICD-10 M87.31 is a billable code used to indicate a diagnosis of other secondary osteonecrosis, shoulder.

Key Diagnostic Point:

M87.31 refers to osteonecrosis of the shoulder that is secondary to other conditions, such as trauma, corticosteroid use, or certain medical conditions like sickle cell disease or systemic lupus erythematosus. Osteonecrosis, also known as avascular necrosis, occurs when blood flow to a bone is disrupted, leading to bone death and potential collapse. In the shoulder, this can result in significant pain, limited range of motion, and functional impairment. Patients may present with symptoms such as shoulder pain that worsens with activity, stiffness, and swelling. 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 with pain relief and physical therapy, or surgical interventions such as core decompression or joint replacement in advanced cases. Understanding the underlying causes and the specific nature of the osteonecrosis is crucial for effective management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between primary and secondary osteonecrosis
  • Identifying the underlying cause of osteonecrosis
  • Need for precise documentation of comorbid conditions
  • Variability in treatment approaches based on severity

Audit Risk Factors

  • Inadequate documentation of the underlying cause
  • Failure to specify the affected site accurately
  • Misclassification of osteonecrosis as osteomyelitis
  • Lack of supporting imaging studies in the medical record

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes including history, physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with shoulder pain and limited range of motion, particularly those with a history of corticosteroid use or trauma.

Billing Considerations

Ensure clear documentation of the cause of osteonecrosis and any associated conditions to support the diagnosis.

Rheumatology

Documentation Requirements

Comprehensive assessment of systemic conditions that may contribute to osteonecrosis, including lab results and treatment history.

Common Clinical Scenarios

Patients with autoimmune diseases presenting with joint pain and potential osteonecrosis.

Billing Considerations

Document the relationship between systemic conditions and the development of osteonecrosis.

Coding Guidelines

Inclusion Criteria

Use M87.31 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant secondary diagnoses that may contribute to the condition

Exclusion Criteria

Do NOT use M87.31 When
  • Exclude primary osteonecrosis codes unless specified

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopy, shoulder, diagnostic

Clinical Scenario

Used when assessing the shoulder joint for osteonecrosis.

Documentation Requirements

Document indications for the procedure and findings.

Specialty Considerations

Orthopedic surgeons should ensure clear linkage between the diagnosis and the procedure performed.

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 ability to capture secondary causes and enhancing data accuracy for treatment and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of osteonecrosis, improving the ability to capture secondary causes and enhancing data accuracy for treatment and research.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of osteonecrosis, improving the ability to capture secondary causes and enhancing data accuracy for treatment and research.

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 are the common causes of secondary osteonecrosis?

Common causes include corticosteroid use, trauma, alcohol abuse, and certain medical conditions such as sickle cell disease and systemic lupus erythematosus.