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M80 vs M84.40XS

M80 (Osteoporosis with current pathological fracture) compared with M84.40XS (Pathological fracture, unspecified site, sequela), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. M80 carries an Excludes1 note covering M84.40XS: “pathological fracture NOS (M84.4)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

No — do not report together. M84.40XS carries an Excludes1 note covering M80: “pathological fracture in osteoporosis (M80.-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

M80Osteoporosis with current pathological fractureM84.40XSPathological fracture, unspecified site, sequela
Billing statusNon-billable header

Report instead: M80.00XA, M80.00XD, M80.00XG, M80.00XK, M80.00XP

Billable
ClassificationM00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
DefinitionOsteoporosis with current pathological fracture is a non-billable ICD-10-CM category code (M80).Pathological fracture, unspecified site, sequela is a billable ICD-10-CM diagnosis code (M84.40S).
7th characterThe appropriate 7th character is to be added to each code from category M80:The appropriate 7th character is to be added to each code from subcategory M84.4:
Includes
osteoporosis with current fragility fracture
Use additional code
code to identify major osseous defect, if applicable (M89.7-)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources