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ICD-10 Guide
ICD-10 CodesM87.364

M87.364

Billable

Other secondary osteonecrosis, right fibula

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

Code Description

ICD-10 M87.364 is a billable code used to indicate a diagnosis of other secondary osteonecrosis, 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 M87.364, the osteonecrosis is secondary, meaning it is a consequence of another underlying condition or factor, such as trauma, corticosteroid use, or certain medical conditions like sickle cell disease or systemic lupus erythematosus. The right fibula, a long bone located in the lower leg, is specifically affected in this diagnosis. Patients may present with pain, swelling, and limited mobility in the affected leg. Diagnosis typically involves imaging studies such as X-rays or MRI, which can reveal changes in bone density and structure. Treatment options may include conservative management with pain relief, physical therapy, or surgical interventions such as bone grafting or joint replacement, depending on the severity of the condition. Accurate coding is essential for proper treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between primary and secondary osteonecrosis
  • Identifying the underlying cause of osteonecrosis
  • Documenting specific anatomical locations accurately
  • Understanding the implications of associated conditions

Audit Risk Factors

  • Inadequate documentation of the underlying cause of osteonecrosis
  • Failure to specify the affected anatomical site accurately
  • Misclassification of primary versus secondary osteonecrosis
  • Lack of supporting imaging or clinical evidence

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 pain in the lower leg, history of corticosteroid use, or previous trauma.

Billing Considerations

Ensure that all relevant comorbidities are documented to support the diagnosis of secondary osteonecrosis.

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 risk factors for osteonecrosis.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use M87.364 When
  • According to ICD
  • CM guidelines, M87
  • 364 should be used when the osteonecrosis is confirmed to be secondary and specifically affects the right fibula
  • Coders must ensure that the underlying cause is documented and coded appropriately

Exclusion Criteria

Do NOT use M87.364 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 should ensure that the procedure is justified based on clinical findings.

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. M87.364 provides a clear indication of the affected site and the nature of the condition, which is crucial for appropriate management.

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. M87.364 provides a clear indication of the affected site and the nature of the condition, which is crucial for appropriate management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of osteonecrosis, improving the accuracy of diagnosis and treatment tracking. M87.364 provides a clear indication of the affected site and the nature of the condition, which is crucial for appropriate management.

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.