ICD-10 M80
Non-Billable HeaderOsteoporosis with current pathological fracture
About ICD-10-CM M80
ICD-10-CM code M80 represents Osteoporosis with current pathological fracture. This is a non-billable header code in the Musculoskeletal and Connective Tissue chapter (block M80). The 2026 edition of ICD-10-CM M80 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with M80. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- collapsed vertebra NOS (M48.5)
- pathological fracture NOS (M84.4)
- wedging of vertebra NOS (M48.5)
Type 2 Excludes
Not included here, the excluded code is not part of M80, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- personal history of (healed) osteoporosis fracture (Z87.310)
Includes
- osteoporosis with current fragility fracture
Use Additional Code
When coding M80, also report these additional codes when applicable.
- code to identify major osseous defect, if applicable (M89.7-)
Coding Notes
Seven Chr Note
- The appropriate 7th character is to be added to each code from category M80:
Medicare LCD Coverage for M80
Local Coverage Determinations (LCDs) from CMS MACs that list M80 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing M80.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but M80 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with M80
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To M80
Other codes in section M80-M85 (Disorders of bone density and structure).
ICD-10 M80, Billing FAQ
Is ICD-10 code M80 billable? +
No, M80 is a non-billable header code. Use a more specific child code from block M80 when submitting claims.
What codes are Type 1 Excludes for M80? +
Type 1 Excludes (never code together with M80): collapsed vertebra NOS (M48.5); pathological fracture NOS (M84.4); wedging of vertebra NOS (M48.5)
What codes are Type 2 Excludes for M80? +
Type 2 Excludes (may be coded together when both conditions exist): personal history of (healed) osteoporosis fracture (Z87.310)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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