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M80.0AXA ICD-10-CM Code: Age-related osteoporosis with current pathological fracture, other site, 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, Appendix B.

  • MS-DRG 521 — HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC (MDC 08)
  • MS-DRG 522 — HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC (MDC 08)
  • 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.

Official Registry Overview & Definition

Age-related osteoporosis with current pathological fracture, other site, initial encounter for fracture is a billable ICD-10-CM diagnosis code (M80.0AA).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for M80.0AXA 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 generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

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 Compared Codes

The official Excludes notes on M80.0AXA name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2021 — 2020-10-01
    Added to the code set
    Age-related osteoporosis with current pathological fracture, other site, initial encounter for fracture
    FY2021 changes

Verify Before Coding

  • Age-restricted: the Medicare Code Editor lists this as a adult (age 15-124) diagnosis; other ages are presumed incorrect.
  • CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Contextual Map

Every relationship of M80.0AXA in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • M00-M99 — Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) (M00-M99) [Hierarchy]
  • M80-M85 — Disorders of bone density and structure [Hierarchy]

Referenced by Excludes1 notes (10)

  • E55 — Vitamin D deficiency [Excludes1](via M80.-): “osteoporosis (M80.-)” · check together
  • E83.3 — Disorders of phosphorus metabolism and phosphatases [Excludes1](via M80.-): “osteoporosis (M80.-)” · check together
  • M43 — Other deforming dorsopathies [Excludes1](via M80.-): “spinal curvature in osteoporosis (M80.-)” · check together
  • M48.4 — Fatigue fracture of vertebra [Excludes1](via M80.-): “pathological fracture of vertebra due to osteoporosis (M80.-)” · check together
  • M48.5 — Collapsed vertebra, not elsewhere classified [Excludes1](via M80.-): “pathological fracture of vertebra due to osteoporosis (M80.-)” · check together
  • M81 — Osteoporosis without current pathological fracture [Excludes1](via M80.-): “osteoporosis with current pathological fracture (M80.-)” · check together
  • M84.3 — Stress fracture [Excludes1](via M80.-): “pathological fracture due to osteoporosis (M80.-)” · check together
  • M84.4 — Pathological fracture, not elsewhere classified [Excludes1](via M80.-): “pathological fracture in osteoporosis (M80.-)” · check together
  • and 2 more

Referenced by Excludes2 notes

  • N95 — Menopausal and other perimenopausal disorders [Excludes2](via M80.0.-): “postmenopausal osteoporosis with current pathological fracture (M80.0-)” · check together

Referenced by Code First instructions

  • M89.7 — Major osseous defect [Code First](via M80.-): “osteoporosis (M80.-, M81.-)” · check together

Referenced by Code Also instructions

  • Z91.B — Personal risk factor of exposure to diethylstilbestrol [Code Also](via M80.-): “osteoporosis (M80.-)” · check together

Clinical classification (CCSR)

  • MUS013 — Osteoporosis [CCSR]
  • MUS014 — Pathological fracture, initial encounter [CCSR]

Potential MS-DRG

  • CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”
  • DRG 521 — HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC [MS-DRG]: “HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC (MDC 08)”
  • DRG 522 — HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC [MS-DRG]: “HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC (MDC 08)”
  • DRG 542 — PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC [MS-DRG]: “PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC (MDC 08)”
  • DRG 543 — PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC [MS-DRG]: “PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC (MDC 08)”
  • DRG 544 — PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC [MS-DRG]: “PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC (MDC 08)”
  • DRG 791 — PREMATURITY WITH MAJOR PROBLEMS [MS-DRG]: “PREMATURITY WITH MAJOR PROBLEMS (MDC 15)”
  • DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS [MS-DRG]: “FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)”

MDC crossing · procedures (18508)

  • MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue [MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period [MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 005T0ZZ — Destruction of Spinal Meninges, Open Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T3ZZ — Destruction of Spinal Meninges, Percutaneous Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T4ZZ — Destruction of Spinal Meninges, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Endoscopic Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0Z3 — Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0ZZ — Destruction of Cervical Spinal Cord, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • and 18503 more

Nearest codes (40)

  • M80 — Osteoporosis with current pathological fracture [Sibling]
  • M80.072D — Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with routine healing [Sibling]
  • M80.072G — Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with delayed healing [Sibling]
  • M80.072K — Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with nonunion [Sibling]
  • M80.072P — Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with malunion [Sibling]
  • M80.072S — Age-related osteoporosis with current pathological fracture, left ankle and foot, sequela [Sibling]
  • M80.079 — Age-related osteoporosis with current pathological fracture, unspecified ankle and foot [Sibling]
  • M80.079A — Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, initial encounter for fracture [Sibling]
  • and 32 more

Change history

  • FY2021 — Added to the code set [Change history]

Referenced by Other Codes

Clinical classification (AHRQ CCSR):MUS013 — Osteoporosis (default); MUS014 — Pathological fracture, initial encounter.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Potential MS-DRG Relationships (FY2026)

CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 164 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 7 MS-DRGs: DRG 521 (MDC 08), DRG 522 (MDC 08), DRG 542 (MDC 08), DRG 543 (MDC 08), DRG 544 (MDC 08), DRG 791 (MDC 15), DRG 793 (MDC 15).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Official ICD-10-CM tabular notes on other codes that name M80.0AXA or its code family.

10 Excludes1 notes across 3 chapters: E55 (via M80.-), E83.3 (via M80.-), M43 (via M80.-), M48.4 (via M80.-), M48.5 (via M80.-), M81 (via M80.-), M84.3 (via M80.-), M84.4 (via M80.-), M84.6 (via M80.-), R29.890 (via M80.-).

1 Excludes2 notes: N95 (via M80.0.-).

1 Code First instructions: M89.7 (via M80.-).

1 Code Also instructions: Z91.B (via M80.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Does M80.0AXA 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 M80.0AXA in its code family, with their registry titles.

  • 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
  • M80.0A — Age-related osteoporosis with current pathological fracture, other site
  • M80.0AXD — Age-related osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with routine healing
  • M80.0AXG — Age-related osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with delayed healing
  • M80.0AXK — Age-related osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with nonunion
  • M80.0AXP — Age-related osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with malunion
  • M80.0AXS — Age-related osteoporosis with current pathological fracture, other site, sequela

View all codes in the M80 family