M80.8AXD vs M84.4
M80.8AXD (Other osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with routine healing) compared with M84.4 (Pathological fracture, not elsewhere classified), 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. M80.8AXD carries an Excludes1 note covering M84.4: “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. M84.4 carries an Excludes1 note covering M80.8AXD: “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
| M80.8AXDOther osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with routine healing | M84.4Pathological fracture, not elsewhere classified | |
|---|---|---|
| Billing status | Billable | Non-billable header Report instead: M84.40XA, M84.40XD, M84.40XG, M84.40XK, M84.40XP |
| Classification | M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) | M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) |
| Definition | Other osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with routine healing is a billable ICD-10-CM diagnosis code (M80.8AD). | Pathological fracture, not elsewhere classified is a non-billable ICD-10-CM category code (M84.4). |
| 7th character | The 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 | Chronic fracture Pathological fracture NOS |
| Use additional code | code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5) 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