Health Information Management

Tip: Coding for osteoporosis and fractures in ICD-10-CM

APCs Insider, May 25, 2012

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ICD-10-CM code category M80- (osteoporosis with current pathologic fracture) denotes fractures caused by osteoporosis. Coders should only report a code from the M80- series when a patient has a current pathologic fracture at the time of the encounter.

When coding for the fracture, select the code based on the site of the fracture, not the location of the ­osteoporosis. Consider the following examples of codes that denote a pathologic fracture with osteoporosis:

  • M80.011, age-related osteoporosis with current pathologic fracture, right shoulder
  • M80.022, age-related osteoporosis with current pathologic fracture, left humerus
  • M80.041, age-related osteoporosis with current pathologic fracture, right hand
  • M80.871, other osteoporosis with current pathologic fracture, right ankle and foot

As with other pathologic fracture codes, those that denote pathologic fractures with osteoporosis include laterality. Some codes do offer options for unspecified laterality, such as unspecified shoulder, humerous, ankle, or foot.

Note that codes for pathologic fractures with ­osteoporosis also require a seventh character to indicate episode of care.

The tip is adapted from “Fracture coding in ICD-10-CM requires greater specificity” in the May Briefings on APCs.



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