2025 ICD-10-CM code M80
Osteoporosis with current pathological fracture.Includes osteoporosis with current fragility fracture.
Use 7th character to specify the episode of care: A (initial encounter), D (subsequent encounter with routine healing), G (subsequent encounter with delayed healing), K (subsequent encounter with nonunion), P (subsequent encounter with malunion), S (sequela).
Medical necessity is established by the presence of a fracture due to weakened bone structure caused by osteoporosis.A minor trauma or even normal activity may cause a fracture in patients with osteoporosis.
Diagnosis involves patient history, physical exam (range of motion, muscle strength), imaging (X-ray, MRI, CT, DEXA), and lab tests (ESR). Treatment includes pain medication, bracing/splinting, dietary changes, calcium supplements, lifestyle changes (e.g., quitting smoking), exercise, surgery, and treating the underlying osteoporosis.
- Diseases of the musculoskeletal system and connective tissue (M00-M99)
- Osteopathies and chondropathies (M80-M94)
In simple words: Osteoporosis with a current broken bone means the bone broke because it was weakened by osteoporosis. This usually happens from a fall from standing height or less, and often affects the spine, hip, or wrist.
Osteoporosis with current pathological fracture refers to a break in the continuity of a bone that occurs because the bone is weakened as a result of osteoporosis. It is generally caused by a fall from a standing height or lower and usually involves the spine, hip, or wrist. It includes osteoporosis with current fragility fracture.
Example 1: A 65-year-old female with a history of osteoporosis falls from standing height and fractures her hip., A 70-year-old male with osteoporosis experiences a spontaneous vertebral compression fracture while bending over., An 80-year-old female with osteoporosis fractures her wrist after a minor fall.
Documentation should include the type of fracture, location, laterality, presence/absence of fracture, episode of care, and underlying cause (osteoporosis).
** Excludes1: collapsed vertebra NOS (M48.5), pathological fracture NOS (M84.4), wedging of vertebra NOS (M48.5). Excludes2: personal history of (healed) osteoporosis fracture (Z87.310).
- Specialties:Orthopedics, Endocrinology, Geriatrics, Family Medicine
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Office, Outpatient Hospital, Skilled Nursing Facility