2025 ICD-10-CM code M80.0
Age-related osteoporosis with current pathological fracture.
Medical necessity is established by the presence of a fracture caused by osteoporosis.The documentation should support the diagnosis and treatment plan.
Diagnosis involves patient history, physical exam (range of motion, muscle strength), imaging (X-rays, MRI, CT, DEXA scans), and lab tests (ESR). Treatment includes pain medication, bracing/splinting, dietary changes, calcium supplements, lifestyle modifications (e.g., quitting smoking), exercise, surgery for the fracture, and treating the underlying osteoporosis.
- Diseases of the musculoskeletal system and connective tissue (M00-M99)
- Osteopathies and chondropathies (M80-M94)
In simple words: This means a bone has broken because it was weakened by age-related osteoporosis.This type of break happens even without a major injury.
This code signifies a current pathological fracture due to age-related osteoporosis.A pathological fracture occurs when a bone breaks due to weakness caused by a disease, rather than from significant trauma.
Example 1: A 70-year-old female falls from standing height and fractures her hip.DEXA scan confirms osteoporosis., An 80-year-old male with known osteoporosis experiences sudden back pain after bending over.X-rays reveal a vertebral compression fracture., A 75-year-old female with a history of osteoporosis develops wrist pain after a minor fall.Diagnosis reveals a distal radius fracture.
Documentation should include the type of fracture, location, laterality, presence or absence of a fracture, episode of care (initial or subsequent), and supporting clinical findings like imaging and lab results.
** For proper coding, it's crucial to differentiate a pathological fracture due to osteoporosis from a fracture caused primarily by trauma.The underlying osteoporosis is the key factor making this a pathological fracture.
- Specialties:Orthopedics, Endocrinology, Geriatrics, Family Medicine, Internal Medicine
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Emergency Room - Hospital, Office, Independent Clinic, Federally Qualified Health Center