M81.6 — Localized osteoporosis [Lequesne]
M81.6 is a billable, specific ICD-10-CM code for localized osteoporosis [lequesne]. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- Sudeck's atrophy (M89.0)
Excludes1 inherited from the categories above M81.6
These are not written on M81.6, but they bind it: a note on a category applies to every code beneath it. Billing M81.6 with anything listed here is a denial.
Risk adjustment
M81.6 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
M81.6 is named in 27 Medicare coverage policies — 20 listing it as supporting medical necessity, and 7 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
- A58883Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58893Billing 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
How M81.6 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 M81.6.
- Osteoporosis›Lequesne
- Osteoporosis›localized
Code history
M81.6 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share M81. If M81.6 is not quite right, the correct code is usually one of these.
Questions about M81.6
- Is M81.6 a billable ICD-10-CM code?
- Yes. M81.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M81.6 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 M81.6?
- M81.6 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 M81.6 (M81) and apply to it just the same.