2025 ICD-10-CM code M85
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Osteopathies and chondropathies - Other disorders of bone density and structure Diseases of the musculoskeletal system and connective tissue (M00-M99) Feed
Other disorders of bone density and structure, unspecified site.
Modifiers may be applicable depending on the circumstances of the visit and the specific services provided. Consult appropriate coding guidelines and payer specifications.
Medical necessity is established based on the presence of symptoms, confirmation of the diagnosis through appropriate imaging and/or other tests, and the need for treatment to alleviate symptoms and improve the patient's condition.The specifics of medical necessity may vary based on payer requirements.
Diagnosis is based on patient history, physical exam, and imaging studies. Treatment may involve medication management, physical therapy, bracing, casting, and surgical intervention.The clinical responsibility depends on the specific condition and may involve orthopedists, rheumatologists, or other specialists.
- Diseases of the musculoskeletal system and connective tissue (M00-M99)
- M80-M85 (Disorders of bone density and structure)
In simple words: This code covers various problems with bone strength and structure not listed elsewhere, such as certain types of bone cysts or weakening from too much fluoride. Doctors use X-rays and other scans to diagnose these conditions. Treatment might include pain relievers, supportive devices (braces), calcium supplements, physical therapy, casts for broken bones, and possibly surgery.
This code encompasses a variety of bone conditions not specified elsewhere, affecting bone density and structure.Examples include monostotic fibrous dysplasia, skeletal fluorosis, osteitis condensans ilii, and bone cysts.Diagnosis relies on patient history, physical examination, and imaging (X-rays, MRI, CT scans, DXA scans). Treatment may involve analgesics, bracing/splinting, nutritional supplements (calcium), physical therapy, casting (for fractures), and surgery.
Example 1: A 50-year-old female presents with pain in her left thigh. Imaging reveals a large bone cyst.Code M85 is used to bill for the diagnosis and management of the bone cyst., A 65-year-old male with a history of skeletal fluorosis exhibits increased bone density and pain. Code M85 is used to reflect the diagnosis and treatment plan involving pain management and monitoring., A 30-year-old patient presents with monostotic fibrous dysplasia affecting a single bone in their arm. Imaging confirms the diagnosis, and code M85 is used to report the condition and any related treatment, such as pain control and possible surgical intervention.
Detailed patient history, physical examination findings, imaging reports (X-rays, MRI, CT, DXA scans), laboratory results (if any), treatment plan, and progress notes.
** This code is for unspecified disorders of bone density and structure.Always strive for the most specific code possible.Review the complete ICD-10-CM manual for the most up-to-date guidelines and information.
- Payment Status: Active
- Specialties:Orthopedics, Rheumatology, Radiology
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center