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Compare/M80 vs M84.60XP

M80 vs M84.60XP

M80 (Osteoporosis with current pathological fracture) compared with M84.60XP (Pathological fracture in other disease, unspecified site, subsequent encounter for fracture with malunion), 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. M84.60XP 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 fractureM84.60XPPathological fracture in other disease, unspecified site, subsequent encounter for fracture with malunion
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 in other disease, unspecified site, subsequent encounter for fracture with malunion is a billable ICD-10-CM diagnosis code (M84.60P).
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 M84.6:
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