M80.08XA ICD-10-CM Code: Age-related osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Inpatient Payment Groups (MS-DRG)
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0 (FY2026), Appendix B.
- MS-DRG 542 — PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC (MDC 08)
- MS-DRG 543 — PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC (MDC 08)
- MS-DRG 544 — PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC (MDC 08)
- MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
- MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Risk Adjustment (CMS-HCC)
Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.
- HCC 401 — Vertebral Fractures without Spinal Cord Injury
Other models: CMS-HCC V22 HCC 169 · RxHCC V08 HCC 87
Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.
Code Set: Valid FY2026 and FY2027. FY2026 took effect October 1, 2025.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for M80.08XA in the official ICD-10-CM tabular list.
Includes
Conditions the official ICD-10-CM tabular list includes under this code.
- osteoporosis with current fragility fracture
Excludes1 — Not Coded Here
Conditions that can never be reported with this code; the two are mutually exclusive.
- collapsed vertebra NOS (M48.5)
- pathological fracture NOS (M84.4)
- wedging of vertebra NOS (M48.5)
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- personal history of (healed) osteoporosis fracture (Z87.310)
Use Additional Code
Supplementary codes the tabular list directs you to add.
- Use additional code to identify major osseous defect, if applicable (M89.7-)
Frequently Asked Questions (FAQ) & Clinical Guidance
Does M80.08XA require a 7th character?
Yes. The appropriate 7th character is to be added to each code from category M80:.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to M80.08XA in its code family, with their registry titles.
- M80.079G — Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with delayed healing
- M80.079K — Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with nonunion
- M80.079P — Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with malunion
- M80.079S — Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, sequela
- M80.08 — Age-related osteoporosis with current pathological fracture, vertebra(e)
- M80.08XD — Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with routine healing
- M80.08XG — Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with delayed healing
- M80.08XK — Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with nonunion
- M80.08XP — Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with malunion
- M80.08XS — Age-related osteoporosis with current pathological fracture, vertebra(e), sequela