Is M80.88 a billable ICD-10-CM code?

No. M80.88 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M80.88 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).

M80.88

M80.88 — Other osteoporosis with current pathological fracture, vertebra(e)

Non-billable headerICD-10-CM

M80.88 is a non-billable header ICD-10-CM code for other osteoporosis with current pathological fracture, vertebra(e). 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

Risk adjustment

M80.88 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.

How M80.88 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to M80.88.

Collapse›vertebra›in›osteoporosis
Osteoporosis›disuse›with current pathological fracture›vertebra
Osteoporosis›specified type NEC›with pathological fracture›vertebra
Collapse›vertebra›in›osteoporosis›cervical region
Collapse›vertebra›in›osteoporosis›cervicothoracic region
Collapse›vertebra›in›osteoporosis›lumbar region
Collapse›vertebra›in›osteoporosis›lumbosacral region
Collapse›vertebra›in›osteoporosis›multiple sites
Collapse›vertebra›in›osteoporosis›occipito-atlanto-axial region
Collapse›vertebra›in›osteoporosis›sacrococcygeal region
Collapse›vertebra›in›osteoporosis›thoracic region
Collapse›vertebra›in›osteoporosis›thoracolumbar region

Code to one of these instead M80.88

6 child codes. Green means billable.

Related codes at this level

Codes that share M80.8. If M80.88 is not quite right, the correct code is usually one of these.

Questions about M80.88

Is M80.88 a billable ICD-10-CM code?: No. M80.88 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M80.88 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).