M80.8B1G — Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with delayed healing
M80.8B1G is a billable, specific ICD-10-CM code for other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with delayed healing. It is valid for submission on a claim.
7th character "G" — subsequent encounter for fracture with delayed healing
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
M80.8B1G 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.
Medicare coverage
M80.8B1G is named in 30 Medicare coverage policies — 25 listing it as supporting medical necessity, and 5 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59434Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59764Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
Related codes at this level
Codes that share M80.8B1. If M80.8B1G is not quite right, the correct code is usually one of these.
- M80.8B1AOther osteoporosis with current pathological fracture, right pelvis, initial encounter for fracture
- M80.8B1DOther osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with routine healing
- M80.8B1KOther osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with nonunion
- M80.8B1POther osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with malunion
- M80.8B1SOther osteoporosis with current pathological fracture, right pelvis, sequela
Questions about M80.8B1G
- Is M80.8B1G a billable ICD-10-CM code?
- Yes. M80.8B1G is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M80.8B1G 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).