ICD-10 M81
Non-Billable HeaderOsteoporosis without current pathological fracture
About ICD-10-CM M81
ICD-10-CM code M81 represents Osteoporosis without current pathological fracture. This is a non-billable header code in the Musculoskeletal and Connective Tissue chapter (block M81). The 2026 edition of ICD-10-CM M81 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 M81. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- osteoporosis with current pathological fracture (M80.-)
- Sudeck's atrophy (M89.0)
Use Additional Code
When coding M81, also report these additional codes when applicable.
- code to identify:
- major osseous defect, if applicable (M89.7-)
- personal history of (healed) osteoporosis fracture, if applicable (Z87.310)
Medicare LCD Coverage for M81
Local Coverage Determinations (LCDs) from CMS MACs that list M81 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 M81.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but M81 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with M81
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 M81
Other codes in section M80-M85 (Disorders of bone density and structure).
ICD-10 M81, Billing FAQ
Is ICD-10 code M81 billable? +
No, M81 is a non-billable header code. Use a more specific child code from block M81 when submitting claims.
What codes are Type 1 Excludes for M81? +
Type 1 Excludes (never code together with M81): osteoporosis with current pathological fracture (M80.-); Sudeck's atrophy (M89.0)
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team