ICD-10: M86.061

ICD-10 code M86.061 refers to Acute hematogenous osteomyelitis of the right tibia and fibula. Here are the clinical details and descriptions associated with this condition:

Clinical Description

• Definition: Acute hematogenous osteomyelitis is an infection of the bone that typically occurs when bacteria spread through the bloodstream (hematogenous) to the bone tissue. This condition can also arise from infections in nearby tissues or as a result of direct inoculation, such as from a fracture or surgical procedure [3][5].

• Common Pathogen: The most frequent causative agent of osteomyelitis is Staphylococcus aureus, which can lead to significant bone infection if not treated promptly [5][9].

Symptoms

• Symptoms may include localized pain, swelling, redness, and warmth over the affected area. Patients may also experience systemic symptoms such as fever and malaise [3].

Diagnosis

• Diagnosis typically involves a combination of clinical evaluation, imaging studies (like X-rays or MRI), and laboratory tests to identify the causative organism [3][5].

Treatment

• Treatment usually consists of antibiotics to combat the infection, and in some cases, surgical intervention may be necessary to remove infected tissue or drain abscesses [3].

Coding Information

• Billable Code: M86.061 is a billable diagnosis code, meaning it can be used for billing and insurance purposes. It is included in the ICD-10-CM (Clinical Modification) coding system, which is used for classifying diseases and health conditions [10][12].
• Usage: This code is applicable in all HIPAA-covered transactions and is valid for use from October 1, 2024, to September 30, 2025 [14].

Related Codes

• Other related codes for acute hematogenous osteomyelitis include:
• M86.062: Acute hematogenous osteomyelitis, left tibia and fibula
• M86.069: Acute hematogenous osteomyelitis, unspecified tibia and fibula
• M86.071: Acute hematogenous osteomyelitis, right ankle and foot [1][2].

This comprehensive overview provides essential information regarding the clinical aspects and coding details for ICD-10 code M86.061.

Acute hematogenous osteomyelitis (AHO) is a significant infection that primarily affects the pediatric population, particularly involving the long bones such as the tibia and fibula. Here are the key aspects regarding its clinical presentation, signs, symptoms, and patient characteristics associated with ICD-10 code M86.061:

Clinical Presentation

• Epidemiology: AHO is most commonly seen in children, with Staphylococcus aureus being the predominant microorganism responsible for the infection. Other pathogens may include group A streptococcus and various gram-negative bacteria [8][11].
• Onset: Patients typically present with symptoms after a period of 6 to 8 days of illness, which may include fever and localized pain [4][8].

Signs and Symptoms

• Fever: Often a prominent symptom, indicating systemic infection.
• Localized Pain: Patients may experience significant pain in the affected area, which is often the tibia and fibula in this case.
• Swelling: The area around the infection site may appear swollen and tender to touch.
• Restricted Movement: Patients may exhibit limited range of motion in the affected limb due to pain and swelling.
• Other Symptoms: Additional signs may include redness over the affected area and possible drainage if an abscess forms [4][14].

Patient Characteristics

• Age Group: AHO is particularly prevalent in children, with a higher incidence in those under the age of 5 [4][8].
• Underlying Conditions: Patients with pre-existing conditions such as diabetes or immunocompromised states may be at increased risk for developing osteomyelitis.
• History of Trauma: While AHO can occur without any preceding trauma, a history of recent injury or surgery may be relevant in some cases [11][12].

Diagnosis and Management

• Diagnosis: Diagnosis is typically made based on clinical features, imaging studies (such as X-rays or MRI), and laboratory tests to identify the causative organism [10][11].
• Management: Treatment often involves antibiotics tailored to the identified pathogen, and in some cases, surgical intervention may be necessary to drain abscesses or remove necrotic tissue [4][8].

Understanding these aspects of acute hematogenous osteomyelitis is crucial for timely diagnosis and effective management, particularly in pediatric patients.

The ICD-10 code M86.061 refers specifically to "Acute hematogenous osteomyelitis, right tibia and fibula." Here are some alternative names and related terms associated with this condition:

• Acute Osteomyelitis: This is a general term for the infection of the bone that occurs suddenly and is often caused by bacteria.
• Hematogenous Osteomyelitis: This term indicates that the infection has spread to the bone through the bloodstream.
• Right Tibial Osteomyelitis: This specifies the location of the infection in the right tibia.
• Right Fibular Osteomyelitis: Similar to the above, this term focuses on the infection in the right fibula.
• Acute Bone Infection: A broader term that encompasses any sudden infection of the bone, including osteomyelitis.
• Bacterial Osteomyelitis: This term highlights the common cause of the infection, which is typically bacterial in nature.

These terms can be used interchangeably in various medical contexts, although they may emphasize different aspects of the condition, such as the location or the nature of the infection.

The diagnosis of acute hematogenous osteomyelitis, particularly for the ICD-10 code M86.061, involves several criteria that healthcare professionals typically consider. Here are the key diagnostic criteria:

1. Clinical Presentation:
   - Patients often present with symptoms such as localized pain, swelling, and tenderness in the affected area (in this case, the right tibia and fibula).
   - Systemic symptoms may include fever, chills, and malaise, indicating an infectious process.

2. Imaging Studies:
   - Radiological examinations, such as X-rays, MRI, or CT scans, are crucial. These imaging studies can reveal changes in the bone structure, such as bone edema, abscess formation, or cortical bone destruction.
   - MRI is particularly useful for early detection of osteomyelitis as it can show marrow edema and soft tissue involvement.

3. Laboratory Tests:
   - Blood tests may show elevated white blood cell counts (leukocytosis) and increased inflammatory markers (such as C-reactive protein).
   - Blood cultures can help identify the causative organism, although they may not always be positive.

4. Microbiological Confirmation:
   - If possible, obtaining a sample from the affected area (through aspiration or biopsy) can provide definitive microbiological evidence of infection.

5. Exclusion of Other Conditions:
   - It is essential to rule out other conditions that may mimic osteomyelitis, such as fractures, tumors, or other infections.

6. Patient History:
   - A thorough medical history is important, including any recent infections, trauma, or underlying conditions (like diabetes or immunosuppression) that may predispose the patient to osteomyelitis.

These criteria collectively help in establishing a diagnosis of acute hematogenous osteomyelitis for the specified ICD-10 code, ensuring that the condition is accurately identified and appropriately managed.

The standard treatment approaches for acute hematogenous osteomyelitis, specifically coded as M86.061 for the right tibia and fibula, typically involve a combination of antibiotic therapy and, in some cases, surgical intervention. Here are the key components of the treatment strategy:

Antibiotic Therapy

• Empirical Antibiotics: Initial treatment often starts with empirical antibiotic therapy, which is adjusted based on the suspected causative organisms. Common pathogens include Staphylococcus aureus, including methicillin-resistant strains (MRSA) [6].
• Culture-Sensitive Treatment: Once a causative microorganism is identified through cultures, antibiotic therapy should be tailored to target that specific organism. This is crucial for effective treatment [6].

Surgical Intervention

• Surgical Drainage: In cases where there is an abscess or significant necrotic tissue, surgical intervention may be necessary to drain the infection and remove any dead bone tissue [2].
• Debridement: Surgical debridement may also be performed to remove infected or necrotic bone, which can help in the healing process and reduce the risk of chronic osteomyelitis [8].

Duration of Treatment

• Length of Antibiotic Therapy: The duration of antibiotic treatment can vary but is generally recommended to be at least 4 to 6 weeks, depending on the severity of the infection and the patient's response to therapy [2][4].

Monitoring and Follow-Up

• Regular Monitoring: Patients should be closely monitored for clinical improvement and any potential complications. Follow-up imaging may be necessary to assess the resolution of the infection [8].

Additional Considerations

• Supportive Care: Pain management and supportive care are also important aspects of treatment to ensure patient comfort and facilitate recovery [2].

In summary, the treatment of acute hematogenous osteomyelitis of the right tibia and fibula involves a combination of targeted antibiotic therapy, possible surgical intervention, and careful monitoring to ensure effective resolution of the infection.