Is M80 a billable ICD-10-CM code?

No. M80 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M80 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Disorders of bone density and structure (M80-M85).

What cannot be coded together with M80?

M80 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

M80

M80 — Osteoporosis with current pathological fracture

Non-billable headerICD-10-CM

M80 is a non-billable header ICD-10-CM code for osteoporosis with current pathological fracture. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

The appropriate 7th character is to be added to each code from category M80:

A: initial encounter for fracture
D: subsequent encounter for fracture with routine healing
G: subsequent encounter for fracture with delayed healing
K: subsequent encounter for fracture with nonunion
P: subsequent encounter for fracture with malunion
S: sequela

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

collapsed vertebra NOS (M48.5)
pathological fracture NOS (M84.4)
wedging of vertebra NOS (M48.5)

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

personal history of (healed) osteoporosis fracture (Z87.310)

Use additional code

Add a secondary code to capture the detail described below.

code to identify major osseous defect, if applicable (M89.7-)

Includes

Conditions this code covers.

osteoporosis with current fragility fracture

Other codes that can never be billed with M80

These codes carry an Excludes1 note pointing at M80. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M80 alone.

M43Other deforming dorsopathies
M48.4Fatigue fracture of vertebra
M48.5Collapsed vertebra, not elsewhere classified
M81Osteoporosis without current pathological fracture
M84.3Stress fracture
M84.4Pathological fracture, not elsewhere classified
M84.6Pathological fracture in other disease
R29.890Loss of height

Risk adjustment

M80 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead M80

2 child codes. Green means billable.

Questions about M80

Is M80 a billable ICD-10-CM code?: No. M80 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M80 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Disorders of bone density and structure (M80-M85).
What cannot be coded together with M80?: M80 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.