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ICD-10 Guide
ICD-10 CodesM87.363

M87.363

Billable

Other secondary osteonecrosis, unspecified tibia

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

Code Description

ICD-10 M87.363 is a billable code used to indicate a diagnosis of other secondary osteonecrosis, unspecified tibia.

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 M87.363, the osteonecrosis is secondary, meaning it is a result of another underlying condition or factor, such as trauma, corticosteroid use, or certain medical conditions like sickle cell disease or systemic lupus erythematosus. The unspecified tibia indicates that the specific site within the tibia is not detailed, which can complicate treatment and management. Patients may present with pain, swelling, and limited range of motion in the affected limb. Diagnosis typically involves imaging studies such as X-rays or MRI to assess the extent of bone damage. Treatment options may include conservative management with pain relief, physical therapy, or surgical interventions such as core decompression or joint replacement, depending on the severity of the condition. Understanding the underlying cause of the osteonecrosis is crucial for effective management and prevention of further complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in underlying causes of osteonecrosis
  • Need for precise documentation of secondary causes
  • Potential for misclassification with other bone conditions
  • Variability in treatment approaches based on severity

Audit Risk Factors

  • Inadequate documentation of the underlying cause of osteonecrosis
  • Failure to specify the affected area of the tibia
  • Inconsistent coding of related conditions
  • Lack of imaging or clinical evidence to support diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes on the patient's history, imaging results, and treatment plan.

Common Clinical Scenarios

Patients presenting with joint pain, history of corticosteroid use, or previous trauma.

Billing Considerations

Ensure that all contributing factors to osteonecrosis are documented to support the diagnosis.

Rheumatology

Documentation Requirements

Comprehensive assessment of systemic conditions that may contribute to osteonecrosis.

Common Clinical Scenarios

Patients with autoimmune diseases presenting with joint pain and risk factors for osteonecrosis.

Billing Considerations

Document any relevant laboratory findings or treatment history that may indicate secondary causes.

Coding Guidelines

Inclusion Criteria

Use M87.363 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant secondary conditions that may contribute to the osteonecrosis
  • Ensure that the unspecified nature of the tibia is clearly documented

Exclusion Criteria

Do NOT use M87.363 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 any imaging 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 ability to capture the nuances of the condition and its underlying causes, which can lead to better patient management and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of osteonecrosis, improving the ability to capture the nuances of the condition and its underlying causes, which can lead to better patient 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 are the common causes of secondary osteonecrosis?

Common causes include trauma, corticosteroid use, excessive alcohol consumption, and certain medical conditions such as lupus or sickle cell disease.

How is osteonecrosis diagnosed?

Diagnosis typically involves imaging studies such as X-rays or MRI to assess the extent of bone damage and to rule out other conditions.