Skip to main content

M80 vs M96.840

M80 (Osteoporosis with current pathological fracture) compared with M96.840 (Postprocedural hematoma of a musculoskeletal structure following a musculoskeletal system procedure), from the official CMS tabular data.

Summary

These codes can be reported together when both conditions are documented, because M96.840 lists M80 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named and billing status.M80 is “Osteoporosis with current pathological fracture”; M96.840 is “Postprocedural hematoma of a musculoskeletal structure following a musculoskeletal system procedure”. M80 is a non-billable header; M96.840 is billable.

Registry fact

Can these codes be reported together?

Yes, when both are documented.M96.840 lists M80 under Excludes2: “disorders associated with osteoporosis (M80)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. M80 carries 3 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.M96.840’s tabular entry: “disorders associated with osteoporosis (M80)”. The note covers M80.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

One is a header.M80 is a non-billable header, but M96.840 is not one of its subdivisions.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

M96.840
Postprocedural hematoma of a musculoskeletal structure following a musculoskeletal system procedure
↔
M80
Osteoporosis with current pathological fracture

What we found

Yes, when both are documented.M96.840 carries an Excludes2 note covering M80: “disorders associated with osteoporosis (M80)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

M80Osteoporosis with current pathological fractureM96.840Postprocedural hematoma of a musculoskeletal structure following a musculoskeletal system procedure
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).Postprocedural hematoma of a musculoskeletal structure following a musculoskeletal system procedure is a billable ICD-10-CM diagnosis code (M96.840).
7th characterThe appropriate 7th character is to be added to each code from category M80:—
Includes
osteoporosis with current fragility fracture
—
Excludes1
collapsed vertebra NOS (M48.5)
pathological fracture NOS (M84.4)
wedging of vertebra NOS (M48.5)
—
Excludes2
personal history of (healed) osteoporosis fracture (Z87.310)
arthropathy following intestinal bypass (M02.0-)
complications of internal orthopedic prosthetic devices, implants and grafts (T84.-)
disorders associated with osteoporosis (M80)
periprosthetic fracture around internal prosthetic joint (M97.-)
presence of functional implants and other devices (Z96-Z97)
Use additional code
code to identify major osseous defect, if applicable (M89.7-)
—

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

Edit this comparisonCheck a whole claim

Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources