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ICD-10 Coding for Avascular Necrosis of the Hip(M87.05, M87.15)

Complete ICD-10-CM coding and documentation guide for Avascular Necrosis of the Hip. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Osteonecrosis of the HipIschemic Necrosis of the Hipavn the hip

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Related ICD-10 Code Ranges

Complete code families applicable to Avascular Necrosis of the Hip

M87.0-M87.9Primary Range

Osteonecrosis

This range includes all codes related to osteonecrosis, including avascular necrosis of the hip.

M89.7

Major osseous defect

Used to indicate structural deformities associated with osteonecrosis.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
M87.05Idiopathic aseptic necrosis of bone, pelvic region and thighUse when AVN is confirmed by imaging and no specific cause is identified.
  • MRI confirmation of necrotic lesion
  • No identifiable cause despite workup
M87.15Osteonecrosis due to drugs, pelvic region and thighUse when AVN is linked to drug use, particularly corticosteroids.
  • MRI findings consistent with AVN
  • History of long-term corticosteroid use

Clinical Decision Support

Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.

Key Information: ICD-10 code for avascular necrosis hip

Essential facts and insights about Avascular Necrosis of the Hip

The ICD-10 code for idiopathic avascular necrosis of the hip is M87.05, while drug-induced cases use M87.15.

Primary ICD-10-CM Codes for avascular necrosis hip

M87.05
Idiopathic aseptic necrosis of bone, pelvic region and thigh
Non-billable Code

Decision Criteria

clinical Criteria

  • MRI shows necrotic lesion without identifiable cause.

Applicable To

  • Idiopathic avascular necrosis of femoral head

Excludes

  • Post-traumatic avascular necrosis (M87.25)

Clinical Validation Requirements

  • MRI confirmation of necrotic lesion
  • No identifiable cause despite workup

Code-Specific Risks

  • Risk of using unspecified codes if etiology is known.

Coding Notes

  • Ensure imaging confirms idiopathic nature before coding.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Major osseous defect, pelvic region and thigh

M89.77
Use if there is a collapse or structural deformity present.

Long-term (current) use of systemic steroids

Z79.52
Always use with M87.15 to indicate steroid use.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Osteonecrosis due to previous trauma

M87.25
Use when there is a history of trauma leading to AVN.

Osteonecrosis due to alcohol

M87.35
Use when alcohol abuse is the cause of AVN.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Avascular Necrosis of the Hip to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M87.05.

Impact

Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.

Mitigation Strategy

Thorough patient history taking., Detailed documentation of drug use or trauma.

Impact

Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.

Mitigation Strategy

Identify and document the specific cause of AVN to use the correct code.

Impact

Failure to document the specific cause of AVN can lead to audit issues.

Mitigation Strategy

Ensure thorough documentation of patient history and imaging findings.

Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.

Frequently Asked Questions

Common questions about ICD-10 coding for Avascular Necrosis of the Hip, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Avascular Necrosis of the Hip

Use these documentation templates to ensure complete and accurate documentation for Avascular Necrosis of the Hip. These templates include all required elements for proper coding and billing.

Orthopedic Progress Note

Specialty: Orthopedics

Required Elements

  • Patient history
  • Imaging results
  • Treatment history
  • Physical examination findings

Example Documentation

62M with 8-month history of progressive right groin pain worsening with weight-bearing. MRI demonstrates subchondral crescent sign and necrotic lesion in anterolateral femoral head (ARCO Stage II). No improvement after 12 weeks of protected weight-bearing and NSAIDs. Core decompression recommended.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Hip pain, AVN suspected.
Good Documentation Example
62M with 8-month history of progressive right groin pain worsening with weight-bearing. MRI demonstrates subchondral crescent sign and necrotic lesion in anterolateral femoral head (ARCO Stage II).
Explanation
The good example includes specific imaging findings and stage, which are crucial for accurate coding and treatment planning.

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