M80.862A
Other osteoporosis with current pathological fracture, left lower leg, initial encounter for fracture
HCC risk adjustment mapping
RxHCC V08
Osteoporosis, Vertebral and Pathological Fractures
Coding notes
Excludes 1 never coded together · Excludes 2 may co-exist
code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
Drug-induced osteoporosis with current pathological fracture Idiopathic osteoporosis with current pathological fracture Osteoporosis of disuse with current pathological fracture Postoophorectomy osteoporosis with current pathological fracture Postsurgical malabsorption osteoporosis with current pathological fracture Post-traumatic osteoporosis with current pathological fracture
osteoporosis with current fragility fracture
collapsed vertebra NOS (M48.5) pathological fracture NOS (M84.4) wedging of vertebra NOS (M48.5)
personal history of (healed) osteoporosis fracture (Z87.310)
code to identify major osseous defect, if applicable (M89.7-)
The appropriate 7th character is to be added to each code from category M80:
| Character | Meaning |
|---|---|
| A | initial encounter for fracture |
| D | subsequent encounter for fracture with routine healing |
| G | subsequent encounter for fracture with delayed healing |
| K | subsequent encounter for fracture with nonunion |
| P | subsequent encounter for fracture with malunion |
| S | sequela |
arthropathic psoriasis (L40.5-) certain conditions originating in the perinatal period (P04-P96) certain infectious and parasitic diseases (A00-B99) compartment syndrome (traumatic) (T79.A-) complications of pregnancy, childbirth and the puerperium (O00-O9A) congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99) endocrine, nutritional and metabolic diseases (E00-E88) injury, poisoning and certain other consequences of external causes (S00-T88) neoplasms (C00-D49) symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition (M00-M25) Arthropathies (M00-M25) Includes: Disorders affecting predominantly peripheral (limb) joints (M40-M54) Dorsopathies (M40-M54) (M60-M79) Soft tissue disorders (M60-M79) (M80-M94) Osteopathies and chondropathies (M80-M94)
Official Guidelines for M80.862A
FY 2026 ›Sections that reference M80.862A
- I.C.13.a.1)Bone versus joint
… certain conditions, the bone may be affected at the upper or lower end, (e.g., avascular necrosis of bone, M87, Osteoporosis, M80, M81). …
- I.C.13.dOsteoporosis
… The site codes under category M80, Osteoporosis with current pathological fracture, identify the site of the fracture, not the osteoporosis.
- I.C.13.d.2)Osteoporosis with current pathological fracture
Category M80, Osteoporosis with current pathological fracture, is for patients who have a current pathologic fracture at the time of an …
- I.C.19.c.1)Initial vs. subsequent encounter for fracturesChapter 19
… A code from category M80, not a traumatic fracture code, should be used for any patient with known osteoporosis who suffers a fracture, even if the …
Sections whose FY 2026 text names M80.862A, its M80 category, or a range containing it — the chapter guidance above is the authoritative source.