Is M80.8 a billable ICD-10-CM code?

No. M80.8 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M80.8 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).

M80.8

M80.8 — Other osteoporosis with current pathological fracture

Non-billable headerICD-10-CM

M80.8 is a non-billable header ICD-10-CM code for other 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

Use additional code

Add a secondary code to capture the detail described below.

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Inclusion terms

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

Drug-induced osteoporosis with current pathological fracture
Idiopathic osteoporosis with current pathological fracture
Osteoporosis of disuse with current pathological fracture
Postoophorectomy osteoporosis with current pathological fracture
Postsurgical malabsorption osteoporosis with current pathological fracture
Post-traumatic osteoporosis with current pathological fracture

Other codes that can never be billed with M80.8

These codes carry an Excludes1 note pointing at M80.8. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M80.8 alone.

K91.2Postsurgical malabsorption, not elsewhere classified

Risk adjustment

M80.8 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 M80.8

11 child codes. Green means billable.

Related codes at this level

Codes that share M80. If M80.8 is not quite right, the correct code is usually one of these.

M80.0Age-related osteoporosis with current pathological fracture

Questions about M80.8

Is M80.8 a billable ICD-10-CM code?: No. M80.8 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M80.8 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).