Is M80.0 a billable ICD-10-CM code?

No. M80.0 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M80.0 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 M80.0?

M80.0 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M80.0 (M80) and apply to it just the same.

M80.0

M80.0 — Age-related osteoporosis with current pathological fracture

Non-billable headerICD-10-CM

M80.0 is a non-billable header ICD-10-CM code for age-related 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

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Involutional osteoporosis with current pathological fracture
Osteoporosis NOS with current pathological fracture
Postmenopausal osteoporosis with current pathological fracture
Senile osteoporosis with current pathological fracture

Excludes1 inherited from the categories above M80.0

These are not written on M80.0, but they bind it: a note on a category applies to every code beneath it. Billing M80.0 with anything listed here is a denial.

Written on M80 — Osteoporosis with current pathological fracture

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

Excludes2 inherited from the categories above M80.0

Also inherited, and the opposite of Excludes1: these conditions are not part of M80.0, but a patient can have both, so you may code both.

Written on M80 — Osteoporosis with current pathological fracture

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

Other codes that can never be billed with M80.0

These codes carry an Excludes1 note pointing at M80.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M80.0 alone.

E55Vitamin D deficiency
E83.3Disorders of phosphorus metabolism and phosphatases
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

Risk adjustment

M80.0 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 history

M80.0 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead M80.0

11 child codes. Green means billable.

Related codes at this level

Codes that share M80. If M80.0 is not quite right, the correct code is usually one of these.

M80.8Other osteoporosis with current pathological fracture

Questions about M80.0

Is M80.0 a billable ICD-10-CM code?: No. M80.0 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M80.0 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 M80.0?: M80.0 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M80.0 (M80) and apply to it just the same.