The ICD-10-CM code for osteoporosis screening is Z13.820, “Encounter for screening for osteoporosis”. It is a billable code, used as the diagnosis on a bone-density test ordered for someone with no known osteoporosis. It is usually paired with CPT 77080 for a standard hip-and-spine DXA scan. Once a scan confirms the disease, you move from Z13.820 to the ICD-10 codes for osteoporosis itself, most often M81.0.
Z13.820 at a Glance
Coders usually want the lookup facts first, so here they are in one place. Always confirm against the current fiscal-year ICD-10-CM tabular list, because codes and notes are updated every October.
| Field | Z13.820 |
|---|---|
| Official descriptor | Encounter for screening for osteoporosis |
| Billable? | Yes. It is a complete, valid code at the most specific level (6 characters) |
| Chapter | Chapter 21, Factors influencing health status and contact with health services (Z00–Z99) |
| Hierarchy | Z13 (screening for other diseases and disorders) > Z13.8 (other specified diseases and disorders) > Z13.82 (musculoskeletal disorder) > Z13.820 |
| Sibling code | Z13.828, Encounter for screening for other musculoskeletal disorder |
| Position on claim | First-listed for a routine screening visit or test; can also be an additional code when screening happens during another visit |
Excludes notes that apply to Z13.820
Z13.820 carries no notes of its own. It inherits them from its parent codes, and both are Excludes1 notes, which means the two situations cannot be coded together.
| Inherited from | Note type | What it excludes | Code instead |
|---|---|---|---|
| Z13 (category) | Excludes1 | Encounter for diagnostic examination | Code the sign or symptom (for example a fracture or height loss) |
| Z13.8 | Excludes1 | Screening for malignant neoplasms | Z12.- series |
The practical rule: screening means testing someone without signs or symptoms. If the scan is ordered because of a fragility fracture, vertebral deformity on X-ray, or known low bone mass, it is diagnostic. In that case, code the finding, not Z13.820.
Pairing Z13.820 With DXA and Bone-Density CPT Codes
The ICD-10 code explains why the test was done. The CPT or HCPCS code describes what was done. A screening claim needs both.
| Procedure code | Test | Typical diagnosis pairing |
|---|---|---|
| CPT 77080 | DXA bone density, axial skeleton (hips, pelvis, spine) | Z13.820 for screening; M81.0 or M85.8- for follow-up of known disease |
| CPT 77081 | DXA bone density, appendicular skeleton (forearm, wrist, heel) | Z13.820 when a peripheral scan is used for screening |
| CPT 77078 | CT bone mineral density (QCT), axial skeleton | Z13.820, M81.0 or M85.8-, depending on the reason for the scan |
| HCPCS G0130 | Single-energy X-ray absorptiometry (SEXA), appendicular skeleton | Z13.820 or a diagnosis supporting the test |
Medicare pays for bone mass measurement for specific qualifying groups. Examples are estrogen-deficient women at clinical risk, people on long-term glucocorticoids, and people being monitored on an approved osteoporosis drug. Your Medicare contractor’s coverage policy lists which diagnosis codes support the claim. Some expect a code for the qualifying condition, such as Z78.0 (asymptomatic menopausal state) or Z79.52 (long-term systemic steroid use), alongside or instead of Z13.820. Commercial plans generally accept Z13.820 for guideline-based screening. Check the payer’s policy before the scan, not after the denial.
From Screening to Diagnosis: Which Code the T-Score Supports
A DXA reports a T-score, which compares your bone density with a healthy young adult’s. Standard WHO categories decide which code the result supports:
| T-score | Category | Code on the result or next visit |
|---|---|---|
| −1.0 or higher | Normal | Z13.820 stays as the reason for the encounter |
| Between −1.0 and −2.5 | Osteopenia (low bone mass) | M85.8- (M85.80 if site unspecified) |
| −2.5 or lower | Osteoporosis | M81.0 (or M81.8 if another cause) |
| Any, with a fragility fracture | Osteoporosis with current fracture | M80.- with site and 7th character |
Do not code osteopenia as osteoporosis. A T-score of −2.0 is worth watching, but it does not support M81.0.
M80 vs M81, and Age-Related vs “Other” Osteoporosis
The split is simple. M81 is osteoporosis without a current pathological fracture. M80 is osteoporosis with a current fragility fracture. Within each category you then choose between age-related and “other”:
- M81.0 / M80.0-: age-related osteoporosis. This covers postmenopausal and senile osteoporosis and osteoporosis NOS. Most patients fall here, and it is the usual target of age-related osteoporosis prevention and management.
- M81.8 / M80.8-: other osteoporosis. Use this when a specific cause drives the bone loss, such as drug-induced (for example glucocorticoids), disuse, post-oophorectomy, post-surgical malabsorption or idiopathic osteoporosis. For drug-induced cases, add a code for the adverse effect of the drug.
- M81.6: localized osteoporosis (Lequesne).
Older references list M80.4 or M81.4 for drug-induced osteoporosis. Those codes are no longer in ICD-10-CM, and drug-induced cases now go under M80.8- or M81.8. When a patient on M81.- has a healed osteoporotic fracture in their history, add Z87.310, personal history of (healed) osteoporosis fracture.
M80 Fracture Codes: The 7th Character
Every M80 code needs a 7th character describing the episode of care. It does not describe how old the fracture is.
| 7th character | Meaning |
|---|---|
| A | Initial encounter for fracture (active treatment) |
| D | Subsequent encounter, routine healing |
| G | Subsequent encounter, delayed healing |
| K | Subsequent encounter, nonunion |
| P | Subsequent encounter, malunion |
| S | Sequela |
Worked example: a 72-year-old woman with known postmenopausal osteoporosis falls from standing height and fractures her left upper arm. At the first treatment visit this is M80.022A. Broken down, that is M80.0 (age-related, with current fracture), then 2 (humerus), then 2 (left), then A (initial encounter). At her six-week check with normal healing it becomes M80.022D. Vertebral fractures have no laterality, so a placeholder X fills the gap, as in M80.08XA.
Documentation That Supports the Code
Coders can only assign what the clinician writes down. For osteoporosis and screening claims, the note should state:
- Reason for the scan: routine screening (and the risk factor or age criterion), or a diagnostic reason
- Fracture status: no current fracture, current pathological or fragility fracture, or healed history
- Bone site: vertebra, femur, humerus, forearm, ankle and so on
- Laterality: right or left for limb fractures
- Episode of care: initial, subsequent (and how healing is going) or sequela
- Cause: age-related, or a secondary cause such as steroid use
For how these clinical details drive treatment choices, see our overview of osteoporosis ICD coding and management.
Who Qualifies for a Screening Code
The USPSTF recommends screening women 65 and older, and younger postmenopausal women at increased fracture risk. Many societies also recommend screening men from 70, or earlier if they have risk factors. Risk factors that justify earlier screening include early menopause, long-term glucocorticoids (add Z79.52), a parent who broke a hip, low body weight, smoking, heavy drinking, rheumatoid arthritis and hormone-lowering cancer therapy.
Frequently Asked Questions
What CPT code goes with Z13.820 for a DXA scan?
For a standard hip and spine DXA it is CPT 77080. A peripheral DXA of the forearm or heel is 77081. A CT-based bone density study is 77078, and single-energy X-ray absorptiometry is HCPCS G0130.
Is Z13.820 a billable code?
Yes. Z13.820 is a valid, billable ICD-10-CM code. Its parents, Z13.8 and Z13.82, are headers and cannot be billed.
What does Z13.820 exclude, and when should a diagnostic code be used instead?
Through its parent codes, Z13.820 has Excludes1 notes for diagnostic examinations and for cancer screening (Z12.-). If the patient has a fracture, a suspicious X-ray or known low bone mass, the scan is diagnostic. Code that condition instead.
What is the difference between M80 and M81?
M81 is osteoporosis without a current pathological fracture. M80 is osteoporosis with a current fragility fracture, and it requires a bone site, laterality where relevant, and a 7th-character episode of care.
Can Z13.820 be used for men?
Yes. The code is not sex-restricted. Whether a payer covers the scan depends on its policy and the man’s age or risk factors. For a patient-friendly overview of the wider code family, see osteoporosis ICD-10 for patients and providers.
Key Takeaways
- Z13.820 is the billable screening code; use it only when the patient has no signs, symptoms or known diagnosis.
- Pair it with 77080 (axial DXA), 77081 (peripheral DXA), 77078 (QCT) or G0130 (SEXA).
- After the scan, code the result: M85.8- for osteopenia, M81.0 or M81.8 for osteoporosis, M80.- if there is a current fracture.
- M80 codes need site, laterality and a 7th character (A, D, G, K, P or S).
- Check Medicare contractor and commercial payer policies for accepted diagnosis codes before the scan.
More on bone health is in our osteoporosis guide.
