Antiresorptive Osteonecrosis of the Jaws

by  Find-A-Code™
Jan 9th, 2018

Osteonecrosis is a serious bone disease caused when the bone is starved of its normal blood supply. Because bone is living tissue, without a good supply of oxygenated blood, it becomes weakened and then dies. Scientists have not been able to identify the exact cause of osteonecrosis of the jaws, but they have been able to pinpoint the cause of a specific type called antiresorptive osteonecrosis of the jaws (RONJ). According to an abstract by the National Institutes of Health (NIH) “Nitrogen-containing and non-nitrogen-containing bisphosphonates have been implicated in the development of osteonecrosis of the jaw (ONJ), a condition termed bisphosphonate-related ONJ.” (https://www.ncbi.nlm.nih.gov/pubmed/24655528)

Some commonly prescribed bisphosphonates (Boniva, Fosamax, Actonel, and Reclast), are prescribed for the treatment of osteoporosis to help prevent the breakdown of bone and potentially reduce the number of fractures associated with osteoporosis. Bisphosphonates are also implicated as an underlying cause of atypical femoral fractures and now antiresorptive osteonecrosis of the jaws.

Documentation should adequately link the patient’s condition to the bisphosphonate usage in order to fully report the cause as drug related. The diagnoses for this would include:

If there a major osseous defect of the jaw is also present, an additional code (M89.78) should be reported.