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M87.059
ICD-10-CM
Osteonecrosis of the Hip

Find comprehensive information on Osteonecrosis of the Hip, including clinical documentation tips, ICD-10 codes (M87.3), medical coding guidelines, and healthcare resources. Learn about avascular necrosis of the femoral head, bone death, hip pain diagnosis, treatment options, and stages of osteonecrosis. This resource provides essential information for physicians, coders, and healthcare professionals seeking accurate and up-to-date details on hip osteonecrosis diagnosis and management.

Also known as

Avascular Necrosis of the Hip
AVN of the Hip
Ischemic Necrosis of the Hip

Diagnosis Snapshot

Key Facts
  • Definition : Bone death in the hip joint due to disrupted blood supply.
  • Clinical Signs : Groin pain, stiffness, limited range of motion, worsening with activity.
  • Common Settings : Trauma, corticosteroid use, alcohol abuse, sickle cell disease.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC M87.059 Coding
M87.0-

Osteonecrosis of hip

Bone death in the hip joint due to disrupted blood supply.

M87.-

Osteonecrosis

Bone death in any location due to lack of blood flow.

M00-M99

Diseases of musculoskeletal system

Encompasses various bone, joint, and muscle disorders.

Code-Specific Guidance

Decision Tree for

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

Is the osteonecrosis traumatic?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Hip bone death due to poor blood supply
Hip joint inflammation, not infection
Hip fracture, traumatic origin

Documentation Best Practices

Documentation Checklist
  • Document laterality (right/left hip)
  • Stage of osteonecrosis (Ficat or ARCO)
  • Symptom onset, duration, and character
  • Causative factors (steroids, trauma, etc.)
  • Imaging findings confirming diagnosis (MRI, X-ray)

Coding and Audit Risks

Common Risks
  • Laterality Coding

    Missing or incorrect laterality (right, left, bilateral) can lead to claim denials and inaccurate data reporting for osteonecrosis of the hip.

  • Specificity of Diagnosis

    Coding to unspecified osteonecrosis (M87.3-) when a more specific code (e.g., traumatic M87.31-, nontraumatic M87.30-) is documented creates compliance and data quality issues.

  • Avascular Necrosis Stage

    Failure to capture the stage of avascular necrosis (AVN) of the hip, when documented, impacts severity and treatment coding, affecting reimbursement and quality metrics.

Mitigation Tips

Best Practices
  • ICD-10 M87, M91-M94: Code ONFH etiology for CDI, compliance.
  • Document pain location, ROM, imaging findings for M87 specificity.
  • Correlate meds (steroids) with ONFH in documentation per HCC guidelines.
  • Query provider for stage, etiology if unspecified for accurate coding.
  • SNOMED CT 22435003: Use for precise ONFH diagnosis, improved CDI.

Clinical Decision Support

Checklist
  • Verify hip pain, limited ROM, antalgic gait (ICD-10: M87.3)
  • Confirm imaging: MRI preferred, X-ray for staging (CPT: 73721)
  • Assess risk factors: corticosteroid use, trauma, alcohol (SNOMED CT: 302569004)
  • Evaluate labs: CBC, ESR, CRP for inflammation markers (LOINC: 26445-4)
  • Correlate patient history, exam, imaging, and labs for accurate diagnosis

Reimbursement and Quality Metrics

Impact Summary
  • Osteonecrosis of the hip reimbursement hinges on accurate ICD-10 (M87, M91-M94) and CPT (27130, 27236) coding, impacting DRG assignment and payment.
  • Quality metrics like length of stay, complication rates (surgical site infection, DVT), and patient-reported outcomes affect value-based payments.
  • Timely documentation and coding of stages (ARCO I-IV) and etiology (traumatic, atraumatic) are crucial for proper reimbursement and quality reporting.
  • Denials related to medical necessity or documentation deficiencies can impact hospital revenue cycle management and profitability.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code M87.x for hip osteonecrosis
  • Specify laterality (left/right)
  • Document etiology if known
  • Add stage of AVN if documented
  • Consider M91.x for post-traumatic

Documentation Templates

Patient presents with complaints of hip pain, consistent with a potential diagnosis of osteonecrosis of the femoral head.  The patient reports experiencing groin pain, thigh pain, and buttock pain, which may radiate to the knee.  Onset of pain is described as (gradual/acute), and the pain is exacerbated by weight-bearing activities and relieved by rest.  The patient reports (limited/significant) limitations in range of motion, specifically with (internal/external) rotation and abduction.  The patient denies any history of trauma to the affected hip.  Risk factors for avascular necrosis of the hip were assessed, including corticosteroid use, history of alcohol abuse, sickle cell disease, and coagulation disorders.  Physical examination revealed tenderness to palpation over the affected hip joint, and a positive Trendelenburg sign may be present.  Imaging studies, including X-rays and potentially MRI of the hip, are ordered to confirm the diagnosis and assess the stage of osteonecrosis.  Differential diagnoses considered include osteoarthritis, labral tear, and trochanteric bursitis.  Preliminary diagnosis is osteonecrosis of the hip (ONFH), pending imaging results.  Treatment plan will be discussed with the patient following confirmation of the diagnosis and may include conservative management with pain medication, physical therapy, activity modification, or surgical intervention such as core decompression, osteotomy, or total hip arthroplasty (THA) depending on the stage of the disease and patient's functional limitations.  Follow-up appointment scheduled in two weeks to review imaging results and finalize the treatment plan.  ICD-10 code M87.3 is considered pending confirmation of the diagnosis.