2025 ICD-10-CM code M86.56
Chronic hematogenous osteomyelitis of the tibia and fibula.
Medical necessity must be established by demonstrating the presence of chronic infection in the tibia and fibula, impacting the patient's function and quality of life.The documentation should support the need for ongoing treatment (medical or surgical) to resolve the infection and prevent further complications.
Providers diagnose the condition based on patient history, physical examination, imaging (X-rays, MRI, bone scan), laboratory tests (CRP, ESR, WBC count), and bone biopsy. Treatment involves antibiotics, pain relievers, and potentially surgery to remove dead bone.
- Diseases of the musculoskeletal system and connective tissue (M00-M99)
- Osteopathies and chondropathies (M80-M94)
In simple words: This refers to a long-lasting bone infection in your lower leg, specifically the tibia and fibula bones. The infection travels to the bones through your blood.It’s important to note this is different from other types of bone infections that can occur in the lower leg.
Other chronic hematogenous osteomyelitis, tibia and fibula. This code represents a chronic infection of the tibia and fibula bones, where the infection has spread through the bloodstream.It is distinct from other forms of osteomyelitis affecting these bones.
Example 1: A patient presents with persistent pain, swelling, and warmth in their lower leg. After a thorough examination, including imaging and blood tests, they are diagnosed with chronic hematogenous osteomyelitis of the tibia and fibula., A child with a history of a neglected “Dhaga syndrome” (a tight band around the limb) develops a chronic infection in the tibia and fibula. Imaging studies confirm osteomyelitis., Following a traumatic injury to the lower leg, a patient develops a deep bone infection that becomes chronic. Cultures and imaging lead to a diagnosis of hematogenous osteomyelitis specifically affecting the tibia and fibula.
Documentation should include evidence of infection (e.g., elevated inflammatory markers, positive cultures), imaging findings confirming osteomyelitis, location (tibia and fibula), and chronicity of the condition. If related to an external cause (like trauma or Dhaga syndrome), this should also be documented.
** This code specifically refers to chronic hematogenous osteomyelitis and should not be used for other types of osteomyelitis or infections in the lower leg.Accurate documentation is crucial to distinguish this condition from others and ensure appropriate treatment.
- Specialties:Orthopedic Surgery, Infectious Disease
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Physician's Office