Other secondary osteonecrosis, multiple sites

This code signifies the death of bone tissue due to an underlying medical condition or external factor, affecting multiple distinct anatomical locations. Unlike primary osteonecrosis, this form is a consequence of another disease process, such as steroid use, alcoholism, or systemic lupus erythematosus. It results in bone collapse and joint destruction if left untreated.

Assign this code when documentation clearly indicates secondary osteonecrosis impacting more than one bone or joint, and the specific site(s) are not further specified or are too numerous to code individually. Supporting documentation should identify the underlying cause of the osteonecrosis and confirm its multifocal presentation.

• Ensure the documentation explicitly states "multiple sites" or lists several affected areas without a more specific code available for the combination.
• Always code the underlying cause of the secondary osteonecrosis first, if known and documented.
• Differentiate from M87.30 (Other secondary osteonecrosis, unspecified site) when multiple sites are clearly identified.