M80.8AXG ICD-10-CM Code: Other osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with delayed healing
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 559 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC (MDC 08)
- MS-DRG 560 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC (MDC 08)
- MS-DRG 561 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC (MDC 08)
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
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for M80.8AXG 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).
- collapsed vertebra NOS (M48.5) Compare M80.8AXG vs M48.5 →
- pathological fracture NOS (M84.4) Compare M80.8AXG vs M84.4 →
- wedging of vertebra NOS (M48.5) Compare M80.8AXG vs 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) Compare M80.8AXG vs Z87.310 →
Use Additional Code
Supplementary codes the tabular list directs you to add.
- Use additional code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
- Use additional code to identify major osseous defect, if applicable (M89.7-)
Change history
- FY2021 — 2020-10-01Added to the code setOther osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with delayed healingFY2021 changes
Verify Before Coding
- Billable — reportable as written.
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 M80.8AXG 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 (11)
- 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
- K91.2 — Postsurgical malabsorption, not elsewhere classified [Excludes1](via M80.8.-): “malabsorption osteoporosis, postsurgical (M80.8-, M81.8)” · 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
- and 3 more
Referenced by Excludes2 notes
- N99 — Intraoperative and postprocedural complications and disorders of genitourinary system, not elsewhere classified [Excludes2](via M80.8.-): “postoophorectomy osteoporosis with current pathological fracture (M80.8-)” · 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)
- MUS015 — Pathological fracture, subsequent encounter [CCSR]
Potential MS-DRG
- 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 559 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC [MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC (MDC 08)”
- DRG 560 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC [MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC (MDC 08)”
- DRG 561 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC [MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC (MDC 08)”
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.”
- 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]
- M80.872K — Other osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with nonunion [Sibling]
- M80.872P — Other osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with malunion [Sibling]
- M80.872S — Other osteoporosis with current pathological fracture, left ankle and foot, sequela [Sibling]
- M80.879 — Other osteoporosis with current pathological fracture, unspecified ankle and foot [Sibling]
- M80.879A — Other osteoporosis with current pathological fracture, unspecified ankle and foot, initial encounter for fracture [Sibling]
- M80.879D — Other osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with routine healing [Sibling]
- M80.879G — Other osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with delayed healing [Sibling]
- and 32 more
Change history
- FY2021 — Added to the code set [Change history]
Referenced by Other Codes
Clinical classification (AHRQ CCSR):MUS015 — Pathological fracture, subsequent encounter (default).
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)
Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.
Named in the grouper logic of 5 MS-DRGs: DRG 521 (MDC 08), DRG 522 (MDC 08), DRG 559 (MDC 08), DRG 560 (MDC 08), DRG 561 (MDC 08).
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 M80.8AXG or its code family.
11 Excludes1 notes across 4 chapters: E55 (via M80.-), E83.3 (via M80.-), K91.2 (via M80.8.-), 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.-) and 1 more.
1 Excludes2 notes: N99 (via M80.8.-).
1 Code First instructions: M89.7 (via M80.-).
1 Code Also instructions: Z91.B (via M80.-).
Frequently Asked Questions (FAQ) & Clinical Guidance
Does M80.8AXG 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 M80.8AXG in its code family, with their registry titles.
- M80.88XP — Other osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with malunion
- M80.88XS — Other osteoporosis with current pathological fracture, vertebra(e), sequela
- M80.8A — Other osteoporosis with current pathological fracture, other site
- M80.8AXA — Other osteoporosis with current pathological fracture, other site, initial encounter for fracture
- M80.8AXD — Other osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with routine healing
- M80.8AXK — Other osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with nonunion
- M80.8AXP — Other osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with malunion
- M80.8AXS — Other osteoporosis with current pathological fracture, other site, sequela
- M80.8B — Other osteoporosis with current pathological fracture, pelvis
- M80.8B1 — Other osteoporosis with current pathological fracture, right pelvis