Osteonecrosis due to drugs, multiple sites

This code signifies the death of bone tissue (osteonecrosis) that is directly attributable to the use of specific medications. It indicates that this bone death is affecting more than one anatomical location within the body. The condition typically results from impaired blood supply to the affected bone(s).

Use this code when documentation clearly links osteonecrosis at multiple sites to drug therapy, such as corticosteroids or bisphosphonates. Supporting documentation should specify the drug etiology and identify at least two distinct anatomical locations of bone necrosis. This code is appropriate for both acute and chronic drug-induced osteonecrosis.

• Always ensure the medical record explicitly states a drug-induced etiology for osteonecrosis.
• Verify that "multiple sites" are documented; if only one site is affected, a more specific code for that site (e.g., M87.11x, M87.12x) should be used.
• Sequence this code as a primary diagnosis when the drug-induced osteonecrosis is the reason for the encounter, or as a secondary diagnosis if it's a co-morbidity.