ICD-10 M80.861K
Billable / Specific CCOther osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with nonunion
About ICD-10-CM M80.861K
ICD-10-CM code M80.861K represents Other osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with nonunion. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M80). The 2026 edition of ICD-10-CM M80.861K became effective on October 1, 2025.
Coding Tips for M80.861K
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
M80.861K is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inpatient DRG Impact, CC
codes Other osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with nonunion. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for M80.861K
Local Coverage Determinations (LCDs) from CMS MACs that list M80.861K as a covered diagnosis.
Showing top 10 of 85 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing M80.861K.
5 Medicare
CPT Codes Commonly Billed with M80.861K
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.
Convert M80.861K to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| M80.861K | 73382 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
ICD-10 M80.861K, Billing FAQ
Is ICD-10 code M80.861K billable? +
Yes, M80.861K is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is M80.861K a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What ICD-9 codes does M80.861K map to? +
Per CMS GEMs, M80.861K maps to ICD-9 codes: 73382. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 1, 2026.
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