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M80.00XA
ICD-10-CM
Osteoporosis with Fracture

Find information on Osteoporosis with Fracture diagnosis, including clinical documentation, medical coding, and healthcare resources. Learn about ICD-10 codes for Osteoporosis with Pathological Fracture, fragility fracture, and osteoporosis related fracture documentation. Explore resources for healthcare professionals on coding guidelines for osteoporosis with current fracture, history of fracture, and subsequent fracture for accurate medical billing and reimbursement. Discover best practices for documenting osteoporosis fractures in patient charts and understand the difference between traumatic fracture and fragility fracture in the context of osteoporosis.

Also known as

Pathological Fracture due to Osteoporosis
Osteoporotic Fracture

Diagnosis Snapshot

Key Facts
  • Definition : Low bone density leading to increased fracture risk.
  • Clinical Signs : Bone pain, fractures (wrist, spine, hip), loss of height, stooped posture.
  • Common Settings : Primary care, endocrinology, orthopedics, rheumatology.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC M80.00XA Coding
M80-M82

Osteoporosis with current pathological fracture

Fractures due to osteoporosis at specified sites.

M81.0

Postmenopausal osteoporosis with fracture

Osteoporosis occurring after menopause with associated fracture.

S02-S09

Fractures of skull and facial bones

Fractures of the skull and face, some may be due to osteoporosis.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the fracture traumatic?

  • Yes

    Site of fracture?

  • No

    Site of fracture?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Osteoporosis with fracture
Osteopenia
Pathological fracture

Documentation Best Practices

Documentation Checklist
  • Osteoporosis fracture diagnosis code
  • Document bone density T-score
  • Specify fracture location and type
  • Detail acute vs chronic fracture
  • Note any trauma or fall related to fracture

Coding and Audit Risks

Common Risks
  • Specificity of Fracture

    Coding osteoporosis with fracture requires specific fracture site documentation. Unspecified fracture coding leads to underpayment and compliance issues.

  • Traumatic vs. Pathologic

    Distinguishing between traumatic and fragility fractures is crucial for accurate coding. Misclassification impacts severity and reimbursement.

  • Secondary Osteoporosis

    Underlying causes like medications or other conditions contributing to osteoporosis must be documented and coded for complete clinical picture and accurate risk adjustment.

Mitigation Tips

Best Practices
  • Capture Z-codes for aftercare, status post fracture (S/P), and osteoporosis screenings.
  • Ensure proper ICD-10 coding: M80.- for osteoporosis with fracture, M81.- for postmenopausal osteoporosis.
  • Document bone density T-scores for accurate severity staging and risk assessment.
  • Query physicians for fracture specifics: site, type (e.g., pathologic, stress), mechanism.
  • Implement fall risk assessments and prevention programs for osteoporosis patients.

Clinical Decision Support

Checklist
  • Verify low bone mass/density via DEXA scan (ICD-10: M85.80)
  • Document fragility fracture type/location (ICD-10: S02.00-S92.9)
  • Assess secondary causes (medications, diseases)
  • Review fall risk assessment and implement prevention strategies
  • Confirm osteoporosis diagnosis and fracture link in documentation

Reimbursement and Quality Metrics

Impact Summary
  • Osteoporosis Fracture Diagnosis Reimbursement: Coding accuracy impacts MS-DRG assignment and appropriate payment. Proper ICD-10-CM coding (e.g., M80.-, S...) crucial for maximizing reimbursement.
  • Quality Metrics Impact: Osteoporosis fracture rates are quality indicators. Accurate coding affects hospital performance reporting and value-based payments. Coding impacts quality scores (e.g., HACs).
  • Hospital Reporting: Accurate documentation and coding are essential for proper public health reporting. Data integrity affects epidemiological studies and resource allocation.
  • Coding Accuracy: Correctly identifying primary and secondary fractures (pathological vs. traumatic) using ICD-10-CM is critical for accurate reimbursement and quality reporting.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code main fracture first, osteoporosis second
  • Document bone density T-score
  • Specificity of fracture site is key
  • Use Z-codes for aftercare
  • 733.0x for pathologic fracture

Documentation Templates

Patient presents with complaints consistent with osteoporosis and fracture.  Symptoms include [specific symptom, e.g., localized bone pain, back pain, decreased height, stooped posture].  Onset of [symptom] occurred [timeframe] following [precipitating event if applicable, e.g., fall, minor trauma, or spontaneously].  Physical examination reveals [relevant findings, e.g., point tenderness over affected area, limited range of motion, spinal deformity].  Diagnostic imaging, including [specify imaging modality, e.g., DEXA scan, X-ray], confirms [fracture location, e.g., vertebral compression fracture, hip fracture] and indicates low bone mineral density, consistent with osteoporosis.  Patient's medical history includes [relevant medical history, e.g., family history of osteoporosis, early menopause, long-term corticosteroid use, smoking history].  Assessment: Osteoporosis with [fracture type and location].  Plan includes [treatment options, e.g., pain management with analgesics, bisphosphonates for osteoporosis treatment, calcium and vitamin D supplementation, fall prevention education, physical therapy, referral to orthopedics or endocrinology for fracture management and osteoporosis treatment].  Patient education provided regarding the importance of medication adherence, lifestyle modifications for bone health, and follow-up appointments.  ICD-10 codes M80 and [appropriate fracture code, e.g., S22.001A] apply.  Future diagnostic considerations may include bone turnover markers if clinically indicated.  Return to clinic scheduled in [timeframe] for reassessment and monitoring of treatment response.