M81.8 ICD-10-CM Code: Other osteoporosis without current pathological fracture
Compare with another codeCheck this code on a claim
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Tabular directives
- 6 inclusion terms · 2 Excludes1 · 4 use-additional codes
- Risk adjustment
- RxHCC V08 category 87
Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.
What you need to know
Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.
- Use additional codeReport with this code when documented
- Excludes1Never report with this code
- IncludesWhat this code covers
- Drug-induced osteoporosis without current pathological fracture
- Idiopathic osteoporosis without current pathological fracture
- Osteoporosis of disuse without current pathological fracture
- Postoophorectomy osteoporosis without current pathological fracture
Most relevant related codes MedCoder-derived
Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.
Inpatient Payment Groups (MS-DRG)
Potential MS-DRG participation — not a DRG assignment.
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.
- MS-DRG 553 — BONE DISEASES AND ARTHROPATHIES WITH MCC (MDC 08)
- MS-DRG 554 — BONE DISEASES AND ARTHROPATHIES WITHOUT 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.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for M81.8 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026
Trace:FY2027 changesChange historyRelease, file and checksum
Notes without a marker are published on M81.8 itself; “inherited from” names the category or block whose note applies here.
Inclusion Terms
Alternative terms the tabular list files under this code.
- Drug-induced osteoporosis without current pathological fracture
- Idiopathic osteoporosis without current pathological fracture
- Osteoporosis of disuse without current pathological fracture
- Postoophorectomy osteoporosis without current pathological fracture
- Postsurgical malabsorption osteoporosis without current pathological fracture
- Post-traumatic osteoporosis without current pathological 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).
- osteoporosis with current pathological fracture (M80.-) Compare M81.8 vs M80 →
- Sudeck's atrophy (M89.0) Compare M81.8 vs M89.0 →
Source: inherited from M81
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-) inherited from M81
- personal history of (healed) osteoporosis fracture, if applicable (Z87.310) inherited from M81
Coder workflow for M81.8
MedCoder structured workflow — derived from this code’s own official record
Before you code M81.8
- “Other” (NEC) means the condition is specified in the record but no dedicated code captures it. Confirm the documented form is not one a sibling code names before settling on M81.8; if the record states no specifics at all, the unspecified sibling applies instead. “Other” codes are for documented conditions the classification gives no specific code; “unspecified” codes are for records lacking the detail (Guidelines I.A.9.a, I.A.9.b).
See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →
- Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with M81.8. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).
Choose the right path
- Does the documentation support a condition named in M81.8’s Excludes1 note?
Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
No → Continue.
Consider M81.8. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
- The associated condition or complication
- Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
- Open or closed; displaced or nondisplaced
- Defaults apply when the record is silent: closed, and displaced (Guidelines I.C.19.c).
- The conditions the Use Additional Code note names
- Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.
- Any detail beyond this code’s title
- What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.
Official instructions as workflow
Excludes1 — check before selecting M81.8(2 notes)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with M81.8: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
See the official tabular notes · Guidelines I.A.12.a
Use Additional Code — after identifying M81.8(4 notes)
Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with M81.8 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.
See the official tabular notes · Guidelines I.A.13
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: Both the condition M81.8 describes and a condition named in its Excludes1 note are documented for the same encounter.
Coding question: Can both codes be reported?
Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.
Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).
Documentation: A condition the Use Additional Code note names is documented.
Coding question: Is a second code reported with M81.8?
Path: Review the Use Additional Code note and the code it names.
Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Coding context
Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Official Coding Guidelines
Official source data — quoted verbatim from the CMS/NCHS Official Guidelines
Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.
Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
1) Bone versus joint For certain conditions, the bone may be affected at the upper or lower end, (e.g., avascular necrosis of bone, M87, Osteoporosis, M80, M81).
Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
d. Osteoporosis Osteoporosis is a systemic condition, meaning that all bones of the musculoskeletal system are affected. Therefore, site is not a component of the codes under category M81, Osteoporosis without current pathological fracture. The site codes under category M80, Osteoporosis with current pathological fracture, identify the site of the fracture, not the osteoporosis.
Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
1) Osteoporosis without pathological fracture Category M81, Osteoporosis without current pathological fracture, is for use for patients with osteoporosis who do not currently have a pathologic fracture due to the osteoporosis, even if they have had a fracture in the past. For patients with a history of osteoporosis fractures, status code Z87.310, Personal history of (healed) osteoporosis fracture, should follow the code from M81.
Verify Before Coding
- No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
MedCoder-derived relationships — computed from published CMS and AHRQ datasets
Other codes that name M81.8 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
Referenced by 2 Excludes1 notes across 2 chapters: K91.2 — Postsurgical malabsorption, not elsewhere classified, R29.890 — Loss of height (via M81.-).
These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.
Referenced by 1 Excludes2 note: N99 — Intraoperative and postprocedural complications and disorders of genitourinary system, not elsewhere classified.
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
Referenced by 1 Code First instruction: M89.7 — Major osseous defect (via M81.-).
Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.
MS-DRG Grouper Relationships (FY2027)
Potential MS-DRG participation — not a DRG assignment.
FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.
Named in the grouper logic of 2 MS-DRGs: DRG 553 (MDC 08), DRG 554 (MDC 08).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):MUS013 — Osteoporosis (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Related Codes
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Osteoporosis).
M80.839A — Other osteoporosis with current pathological fracture, unspecified forearm, initial encounter for fracture, M80.841A — Other osteoporosis with current pathological fracture, right hand, initial encounter for fracture, M80.842A — Other osteoporosis with current pathological fracture, left hand, initial encounter for fracture, M80.849A — Other osteoporosis with current pathological fracture, unspecified hand, initial encounter for fracture, M80.851A — Other osteoporosis with current pathological fracture, right femur, initial encounter for fracture, M80.852A — Other osteoporosis with current pathological fracture, left femur, initial encounter for fracture, M80.859A — Other osteoporosis with current pathological fracture, unspecified femur, initial encounter for fracture, M80.861A — Other osteoporosis with current pathological fracture, right lower leg, initial encounter for fracture, M80.862A — Other osteoporosis with current pathological fracture, left lower leg, initial encounter for fracture, M80.869A — Other osteoporosis with current pathological fracture, unspecified lower leg, initial encounter for fracture, M80.871A — Other osteoporosis with current pathological fracture, right ankle and foot, initial encounter for fracture, M80.872A — Other osteoporosis with current pathological fracture, left ankle and foot, initial encounter for fracture, M80.879A — Other osteoporosis with current pathological fracture, unspecified ankle and foot, initial encounter for fracture, M80.88XA — Other osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture, M80.8AXA — Other osteoporosis with current pathological fracture, other site, initial encounter for fracture, M80.8B1A — Other osteoporosis with current pathological fracture, right pelvis, initial encounter for fracture, M80.8B2A — Other osteoporosis with current pathological fracture, left pelvis, initial encounter for fracture, M80.8B9A — Other osteoporosis with current pathological fracture, unspecified pelvis, initial encounter for fracture, M81.0 — Age-related osteoporosis without current pathological fracture, M81.6 — Localized osteoporosis [Lequesne], +36 more
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Osteoporosis”; these codes share that main term but sit in a different category of the Tabular List.
M80.02 — Age-related osteoporosis with current pathological fracture, humerus (postmenopausal, with pathological fracture, humerus), M80.03 — Age-related osteoporosis with current pathological fracture, forearm (postmenopausal, with pathological fracture, ulna), M80.04 — Age-related osteoporosis with current pathological fracture, hand (postmenopausal, with pathological fracture, finger), M80.05 — Age-related osteoporosis with current pathological fracture, femur (postmenopausal, with pathological fracture, hip), M80.06 — Age-related osteoporosis with current pathological fracture, lower leg (postmenopausal, with pathological fracture, tibia), M80.07 — Age-related osteoporosis with current pathological fracture, ankle and foot (postmenopausal, with pathological fracture, toe), M80.08 — Age-related osteoporosis with current pathological fracture, vertebra(e) (postmenopausal, with pathological fracture, vertebra), M80.0A — Age-related osteoporosis with current pathological fracture, other site (postmenopausal, with pathological fracture, ilium), M80.0B — Age-related osteoporosis with current pathological fracture, pelvis (postmenopausal, with pathological fracture, pelvis), M80.80 — Other osteoporosis with current pathological fracture, unspecified site (disuse, with current pathological fracture), M80.81 — Other osteoporosis with pathological fracture, shoulder (disuse, with current pathological fracture, scapula), M80.82 — Other osteoporosis with current pathological fracture, humerus (disuse, with current pathological fracture, humerus), M80.83 — Other osteoporosis with current pathological fracture, forearm (disuse, with current pathological fracture, ulna), M80.84 — Other osteoporosis with current pathological fracture, hand (disuse, with current pathological fracture, finger), M80.85 — Other osteoporosis with current pathological fracture, femur (disuse, with current pathological fracture, hip), M80.86 — Other osteoporosis with current pathological fracture, lower leg (disuse, with current pathological fracture, tibia), M80.87 — Other osteoporosis with current pathological fracture, ankle and foot (disuse, with current pathological fracture, toe), M80.88 — Other osteoporosis with current pathological fracture, vertebra(e) (disuse, with current pathological fracture, vertebra), M80.8A — Other osteoporosis with current pathological fracture, other site (disuse, with current pathological fracture, site specified NEC), M80.8B — Other osteoporosis with current pathological fracture, pelvis (disuse, with current pathological fracture, ilium), +2 more
Lab tests where this diagnosis supports Medicare coverage (NCD)
Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.
Contextual Map
Every relationship of M81.8 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.
Run M81.8 with these 12 related codes in Claim Check
Hierarchy
- M00-M99 — Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) (M00-M99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- M80-M85 — Disorders of bone density and structure[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
Use Additional Code (15)
- T36 — Poisoning by, adverse effect of and underdosing of systemic antibiotics[Use Additional Code]: “code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- T37 — Poisoning by, adverse effect of and underdosing of other systemic anti-infectives and antiparasitics[Use Additional Code]: “code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- T38 — Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified[Use Additional Code]: “code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- T39 — Poisoning by, adverse effect of and underdosing of nonopioid analgesics, antipyretics and antirheumatics[Use Additional Code]: “code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- T40 — Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens][Use Additional Code]: “code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- T41 — Poisoning by, adverse effect of and underdosing of anesthetics and therapeutic gases[Use Additional Code]: “code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- T42 — Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs[Use Additional Code]: “code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- T43 — Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified[Use Additional Code]: “code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- and 7 more
Referenced by Excludes1 notes
- K91.2 — Postsurgical malabsorption, not elsewhere classified[Excludes1]: “malabsorption osteoporosis, postsurgical (M80.8-, M81.8)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- R29.890 — Loss of height[Excludes1](via M81.-): “osteoporosis (M80-M81)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
Referenced by Excludes2 notes
- N99 — Intraoperative and postprocedural complications and disorders of genitourinary system, not elsewhere classified[Excludes2]: “postoophorectomy osteoporosis without current pathological fracture (M81.8)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
Referenced by Code First instructions
- M89.7 — Major osseous defect[Code First](via M81.-): “osteoporosis (M80.-, M81.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
Clinical classification (CCSR)
- MUS013 — Osteoporosis[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- DRG 553 — BONE DISEASES AND ARTHROPATHIES WITH MCC[MS-DRG]: “BONE DISEASES AND ARTHROPATHIES WITH MCC (MDC 08)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 554 — BONE DISEASES AND ARTHROPATHIES WITHOUT MCC[MS-DRG]: “BONE DISEASES AND ARTHROPATHIES WITHOUT MCC (MDC 08)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
MDC crossing
- 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. 18,439 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
Index entries
- Osteoporosis (female) (male), disuse[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
- Osteoporosis (female) (male), specified type NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
Nearest codes
- M81 — Osteoporosis without current pathological fracture[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- M81.0 — Age-related osteoporosis without current pathological fracture[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- M81.6 — Localized osteoporosis [Lequesne][Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Reference
Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.
Indexed Clinical Terms (2)
Official source data — entries quoted as published, in the Index’s own lookup phrasing
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
- Coding guidelines Official source data
- ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
- Inpatient payment groups Official source data
- CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder-derived relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder editorial explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources
Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "M81.8 — Other osteoporosis without current pathological fracture." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/m81.8-other-osteoporosis-without-current-pathological-fracture
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionOther osteoporosis without current pathological fracture
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to M81.8 in its code family, with their registry titles.