Avascular necrosis of the hip, also known as osteonecrosis or aseptic necrosis, is a debilitating condition that occurs when blood supply to the femoral head (the ball part of the hip joint) is disrupted. This lack of blood flow leads to bone tissue death, which can eventually cause the bone to collapse and the joint to deteriorate, resulting in significant pain and disability. Accurate diagnosis is crucial for effective management, and a key component of this is the correct diagnosis code. In the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), the diagnosis code M87.059 is used to specify idiopathic aseptic necrosis of the unspecified femur, frequently associated with avascular necrosis of the hip.
What is Avascular Necrosis of the Hip?
Avascular necrosis (AVN) of the hip is a condition where the bone tissue in the femoral head dies due to a lack of blood supply. “Avascular” means lack of blood vessels, and “necrosis” refers to tissue death. While it can affect other bones, the hip joint is a common site. The term “idiopathic” in M87.059 indicates that the aseptic necrosis has no known underlying cause. However, several factors are known to increase the risk of developing AVN of the hip.
Synonyms for Avascular Necrosis of the Hip
Understanding the different terms used to describe this condition can be helpful. Synonyms for avascular necrosis of the hip, often used interchangeably, include:
- Aseptic necrosis of the femur head
- Osteonecrosis of the hip
- Bone infarction of the hip
- Ischemic bone necrosis of the hip
- Avascular necrosis of the capital femoral epiphysis
The ICD-10-CM code M87.059 specifically encompasses these conditions when they are idiopathic and affect the femur in an unspecified manner, typically referring to the hip area.
Symptoms of Avascular Necrosis of the Hip
In the early stages, avascular necrosis of the hip may present with minimal or no symptoms. However, as the condition progresses, pain is the most common symptom. Hip pain related to AVN typically:
- Starts gradually and worsens over time.
- May be felt in the groin, thigh, or buttock.
- Can radiate down to the knee.
- Is often aggravated by weight-bearing activities.
- May become present even at rest, especially at night.
- Can lead to stiffness and reduced range of motion in the hip joint.
- May cause limping as the condition advances.
If left untreated, avascular necrosis of the hip can lead to collapse of the femoral head, resulting in severe arthritis and chronic pain.
Causes and Risk Factors
While the ICD-10-CM code M87.059 is for idiopathic aseptic necrosis, meaning the cause is unknown, several risk factors are strongly associated with the development of avascular necrosis of the hip. These include:
- Corticosteroid use: Long-term or high-dose corticosteroid medications are a significant risk factor.
- Excessive alcohol consumption: Chronic heavy alcohol use is linked to AVN.
- Hip injury: Fractures or dislocations of the hip can disrupt blood supply.
- Certain medical conditions: Conditions like sickle cell anemia, lupus, Crohn’s disease, and Gaucher’s disease increase the risk.
- Radiation therapy or chemotherapy: These treatments can damage blood vessels.
- Decompression sickness (Caisson disease): Changes in pressure can lead to gas bubbles in the blood, blocking blood flow.
In many cases, especially when coded as idiopathic (M87.059), the exact cause may remain undetermined.
Diagnosis of Avascular Necrosis of the Hip
Diagnosing avascular necrosis of the hip involves a combination of medical history review, physical examination, and imaging studies. The diagnostic process often includes:
- Physical Examination: A doctor will assess range of motion, pain location, and gait.
- X-rays: While early AVN may not be visible on X-rays, they can show changes in later stages, such as bone collapse and arthritis.
- Magnetic Resonance Imaging (MRI): MRI is the most sensitive imaging technique for detecting AVN in its early stages, before changes are visible on X-rays. It can show the extent and location of bone damage.
- Bone Scan: A bone scan can also detect AVN, although it is less specific than MRI.
- CT Scan: Computed tomography (CT) scans may be used to evaluate the extent of bone collapse in advanced cases.
The ICD-10-CM code M87.059 is assigned once a diagnosis of idiopathic aseptic necrosis of the unspecified femur (hip) is confirmed through these diagnostic methods.
Treatment Options
Treatment for avascular necrosis of the hip aims to relieve pain, preserve joint function, and prevent or delay the need for joint replacement. Treatment options vary depending on the stage of AVN and the severity of symptoms, and can include:
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Conservative Management (Early Stages):
- Pain medication: Over-the-counter or prescription pain relievers.
- Physical therapy: To improve range of motion and strengthen surrounding muscles.
- Assistive devices: Crutches or walkers to reduce weight-bearing on the hip.
- Medications to manage underlying conditions.
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Surgical Treatments:
- Core decompression: Removing a core of bone to reduce pressure within the bone and stimulate new blood vessel growth.
- Bone grafting: Replacing the damaged bone with healthy bone tissue.
- Vascularized bone graft: A bone graft with its own blood supply, often taken from the fibula.
- Total hip replacement: In advanced cases with significant bone collapse and arthritis, total hip replacement may be necessary to relieve pain and restore function.
The choice of treatment is individualized based on patient factors and the progression of avascular necrosis.
ICD-10-CM Code M87.059: Specific Details
M87.059 – Idiopathic aseptic necrosis of unspecified femur is a billable and specific code in the ICD-10-CM system. This means it is precise enough to be used for reimbursement purposes in healthcare billing and coding.
- Effective Date: The 2025 edition of ICD-10-CM M87.059 became effective on October 1, 2024. The code has been in use since 2016 with no changes through 2025, indicating its established role in medical coding.
- Specificity: The code specifies “unspecified femur,” which in the context of aseptic necrosis, often refers to the hip joint region. While it doesn’t specify right or left femur, it clearly indicates the location (femur/hip) and the nature of the condition (idiopathic aseptic necrosis).
- Applicable To: The code is directly applicable to “Idiopathic aseptic necrosis of hip NOS” (Not Otherwise Specified).
- Synonymous Terms: As previously mentioned, the code is associated with terms like “Avascular necrosis of bone of hip” and “Avascular necrosis of hip,” among others.
- Code History: M87.059 was introduced as a new code in 2016 and has remained unchanged through the 2025 ICD-10-CM updates, demonstrating its continued relevance and accuracy in classifying this condition.
Understanding and correctly applying the Diagnosis Code For Avascular Necrosis Of The Hip, specifically M87.059, is essential for accurate medical record keeping, billing, and epidemiological tracking of this condition. For healthcare professionals, using the most specific and appropriate ICD-10-CM code ensures proper communication and reimbursement within the healthcare system.
