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M87.031
ICD-10-CM
Avascular Necrosis of the Right Hip

Avascular necrosis right hip, also known as osteonecrosis or AVN of the right hip, and ischemic necrosis, is a serious condition affecting hip joint health. Learn about diagnosis, treatment, medical coding, and clinical documentation for avascular necrosis of the right hip. Find information on ICD-10 codes, healthcare provider resources, and treatment options for right hip AVN. This resource supports accurate clinical documentation and coding related to avascular necrosis of the right hip.

Also known as

Osteonecrosis of the Right Hip
AVN of the Right Hip
Ischemic Necrosis of the Right Hip
+1 more

Diagnosis Snapshot

Key Facts
  • Definition : Bone tissue death in the right hip joint due to disrupted blood supply.
  • Clinical Signs : Right hip pain, stiffness, limited range of motion, groin pain, and eventually, joint collapse.
  • Common Settings : Trauma, corticosteroid use, alcohol abuse, sickle cell disease, and dyslipidemia.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC M87.031 Coding
M87.0-

Osteonecrosis

Bone death due to interrupted blood supply.

M91-M94

Other osteopathies

Bone diseases not classified elsewhere.

M00-M25

Arthopathies

Joint disorders excluding traumatic injuries.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the avascular necrosis traumatic?

  • Yes

    Site of fracture?

  • No

    Is there an associated drug use?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Bone tissue death in the right hip due to lack of blood supply.
Bone tissue death in the left hip due to lack of blood supply.
Generalized bone tissue death affecting multiple joints.

Documentation Best Practices

Documentation Checklist
  • Document right hip pain onset, duration, and character.
  • Include imaging findings confirming AVN diagnosis (X-ray, MRI).
  • Specify stage of AVN (Ficat or ARCO classification).
  • Note any contributing factors (steroids, trauma, etc.).
  • Record treatment plan (conservative vs. surgical).

Coding and Audit Risks

Common Risks
  • Laterality Coding

    Coding errors specifying right hip are common. Documentation must clearly state laterality to avoid incorrect coding (ICD-10-CM M87.151).

  • Specificity of AVN

    Coding needs to reflect the specific cause if known (e.g., traumatic, steroid-induced) for accurate reimbursement and data analysis (ICD-10-CM M87.151, M87.251).

  • Clinical Validation of AVN

    Necrosis confirmation is essential. Coders must verify imaging reports or other clinical indicators to ensure AVN is definitively diagnosed for appropriate code assignment.

Mitigation Tips

Best Practices
  • ICD-10 M87.351, core decompression for pain relief
  • Document steroid use, trauma, or other risk factors for AVN hip
  • Regular X-rays, MRIs for early diagnosis, stage progression monitoring
  • Limit weight-bearing, consider assistive devices to reduce hip stress
  • Bisphosphonates may slow AVN progression, consult specialist for guidance

Clinical Decision Support

Checklist
  • Verify right hip pain, limited ROM, and/or groin pain documented.
  • Confirm imaging (MRI, X-ray) supports AVN right hip diagnosis.
  • Check for trauma, corticosteroid use, or other risk factors.
  • Exclude other hip pathologies (OA, fracture, labral tear) in documentation.
  • Document Ficat/ARCO stage if applicable for accurate ICD-10 coding.

Reimbursement and Quality Metrics

Impact Summary
  • Medical billing codes for Avascular Necrosis (AVN) of the Right Hip: accurate ICD-10 coding impacts reimbursement.
  • Coding accuracy for AVN hip impacts hospital case-mix index (CMI) and financial health.
  • Osteonecrosis hip diagnosis reporting accuracy affects quality metrics and hospital value-based payments.
  • Right hip AVN diagnosis coding integrity is key for appropriate reimbursement and data analysis.

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Frequently Asked Questions

Common Questions and Answers

Q: What are the key differential diagnoses to consider when a patient presents with right hip pain suggestive of avascular necrosis?

A: When a patient presents with right hip pain that raises suspicion for avascular necrosis (AVN), also known as osteonecrosis or ischemic necrosis, it's crucial to consider several key differential diagnoses. These include osteoarthritis, transient osteoporosis of the hip, occult hip fracture, inflammatory arthritis (such as rheumatoid arthritis or ankylosing spondylitis), and septic arthritis. Differentiating AVN from these conditions requires a thorough clinical evaluation, including a detailed history, physical examination focusing on range of motion and pain provocation, and imaging studies like X-rays and MRIs. Early diagnosis is essential for effective management. Explore how advanced imaging techniques can aid in distinguishing AVN from other hip pathologies.

Q: How does the staging system for avascular necrosis of the right hip inform treatment decisions in clinical practice?

A: The staging system for avascular necrosis (AVN) of the right hip, often based on the Ficat classification or the Steinberg classification, plays a crucial role in guiding treatment decisions. These systems categorize AVN based on the extent of bone involvement and joint damage, as seen on imaging studies. Early stages (Ficat I-II or Steinberg I-II) might be managed conservatively with pain management, activity modification, and pharmacotherapy like bisphosphonates. However, more advanced stages (Ficat III-IV or Steinberg III-VI), characterized by significant bone collapse and joint space narrowing, often necessitate surgical intervention such as core decompression, osteotomy, or total hip arthroplasty (THA). Consider implementing a staged approach to treatment, tailoring the intervention to the specific stage and the patient's individual needs and functional goals. Learn more about the latest advancements in surgical techniques for managing advanced AVN.

Quick Tips

Practical Coding Tips
  • Code M87.21, right hip AVN
  • Verify laterality: Right hip
  • Check documentation for stage
  • Query physician if etiology unclear
  • Consider ICD-10 combination codes

Documentation Templates

Patient presents with complaints of right hip pain, consistent with a possible diagnosis of avascular necrosis (AVN) of the right hip, also known as osteonecrosis or ischemic necrosis.  The onset of pain was [Onset - e.g., gradual, sudden], described as [Character - e.g., aching, throbbing, sharp] and located in the [Location - e.g., groin, buttock, thigh].  The pain is [Severity - e.g., mild, moderate, severe] and [Frequency - e.g., constant, intermittent], aggravated by [Aggravating factors - e.g., weight-bearing, activity] and relieved by [Relieving factors - e.g., rest, ice].  The patient reports [Impact on daily activities - e.g., limited mobility, difficulty walking, sleep disturbance].  Physical examination reveals [Findings - e.g., limited range of motion in the right hip, tenderness to palpation, antalgic gait].  Differential diagnoses include osteoarthritis, hip impingement, labral tear, and trochanteric bursitis.  Imaging studies, such as an X-ray and MRI of the right hip, have been ordered to evaluate for evidence of bone collapse, subchondral fracture, and marrow edema, consistent with AVN.  Preliminary assessment suggests [Stage of AVN if applicable - e.g., early-stage, late-stage] avascular necrosis of the right hip.  Further evaluation and management will be discussed with the patient, including options for pain management, physical therapy, core decompression, osteotomy, or total hip arthroplasty (THA) depending on the progression of the disease and patient's response to conservative treatment.  ICD-10 code M87.351, Osteonecrosis of right hip, is considered.  Continued monitoring and follow-up are planned.
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