The ICD 10 code for osteoporosis with fracture is category M80, “osteoporosis with current pathological fracture.” In the US version (ICD-10-CM), the two main subcategories are M80.0 for age-related osteoporosis and M80.8 for other osteoporosis, and a complete code also specifies the fracture site, the side of the body, and the type of encounter. For example, M80.08XA describes age-related osteoporosis with a current vertebral fracture at the initial encounter. This guide walks through how the code is built and when to use it instead of the osteoporosis-without-fracture codes.
Why Osteoporosis With Fracture Has Its Own Code
Osteoporosis is a skeletal disorder in which bone strength is reduced, so bones break more easily. It is often silent until a fracture happens, and that fracture is frequently the event that brings it to medical attention. The general ICD 10 code for osteoporosis depends on whether a fracture is present.
A fragility fracture, sometimes called a pathological fracture in this context, is a break caused by force that would not normally fracture healthy bone, such as a fall from standing height. Coding it under M80 links the fracture to its underlying cause. That matters for treatment planning, quality measures, and reimbursement, and it flags the patient for secondary fracture prevention.
Underneath the code is a biological process: when bone-resorbing osteoclasts outpace bone-forming osteoblasts, bone demineralization follows and the skeleton weakens. Our osteoporosis guide covers that background in more detail.
How an M80 Code Is Built
In ICD-10-CM, an M80 code has up to seven characters. Each position adds a specific piece of information.
| Position | What it describes | Examples |
|---|---|---|
| M80 | Category: osteoporosis with current pathological fracture | M80 |
| 4th character | Type of osteoporosis | 0 = age-related; 8 = other |
| 5th character | Fracture site | 1 shoulder, 2 humerus, 3 forearm, 4 hand, 5 femur, 6 lower leg, 7 ankle and foot, 8 vertebra(e) |
| 6th character | Laterality | 1 right, 2 left, 9 unspecified (X placeholder for vertebra) |
| 7th character | Episode of care | A, D, G, K, P, S |
Age-Related vs Other Osteoporosis
M80.0- covers age-related osteoporosis, which includes postmenopausal and senile osteoporosis. M80.8- covers other forms, such as drug-induced osteoporosis (for example, from long-term glucocorticoids), disuse osteoporosis, and osteoporosis after oophorectomy. When a medication is the cause, an additional code identifying the drug’s adverse effect is used alongside it.
The 7th Character
- A – initial encounter for fracture (active treatment)
- D – subsequent encounter with routine healing
- G – subsequent encounter with delayed healing
- K – subsequent encounter with nonunion
- P – subsequent encounter with malunion
- S – sequela (a late effect of the fracture)
Worked Coding Examples
| Clinical scenario | Code |
|---|---|
| Postmenopausal woman, new vertebral compression fracture, first visit | M80.08XA |
| Older man with age-related osteoporosis, right hip (femur) fracture, admitted for surgery | M80.051A |
| Same patient at follow-up, healing as expected | M80.051D |
| Steroid-induced osteoporosis, left wrist (forearm) fracture, initial encounter | M80.832A plus a drug adverse-effect code |
These examples follow the standard ICD-10-CM structure. Always confirm the final code against the current code set and your organization’s coding policy, since annual updates can change details.
M80 vs M81 and Other Related Codes
The most common error is choosing between M80 and M81. M81 is used for osteoporosis without a current pathological fracture, such as M81.0 for age-related osteoporosis with no fracture present.
- Use M80 when the patient has osteoporosis and a current fracture, even after minor trauma that would not break normal bone.
- Use M81 when osteoporosis is present but there is no current fracture.
- Use Z87.310 for a personal history of a healed osteoporosis fracture, typically with an M81 code.
- Screening visits without a diagnosis use a screening Z code; see our article on ICD-10 for osteoporosis screening.
A fracture from major trauma, such as a car accident, is generally coded as a traumatic fracture from the injury chapter rather than as M80, with the osteoporosis coded separately.
Outside the US, the WHO version of ICD-10 organizes M80 by cause rather than by site, with subcategories such as postmenopausal, disuse, and drug-induced osteoporosis with pathological fracture. Check which version your country uses.
Clinical Documentation That Supports the Code
Accurate coding depends on clear documentation. The clinician’s note should state the diagnosis of osteoporosis, the type if known, the fracture site and side, the mechanism of injury, and whether this is the initial or a follow-up encounter.
The diagnosis of osteoporosis is usually confirmed with a DXA (dual-energy X-ray absorptiometry) scan. A T-score of -2.5 or lower at the hip or spine meets the densitometric definition. A fragility fracture of the hip or spine can also support a clinical diagnosis of osteoporosis regardless of the T-score.
When secondary causes are suspected, the workup often includes calcium, vitamin D, kidney and thyroid function, and other tests that help decide between M80.0 and M80.8.
Treatment After an Osteoporotic Fracture
A fracture coded under M80 should trigger treatment, not just fracture repair. Standard options include bisphosphonates, denosumab, and anabolic agents such as teriparatide for people at very high risk. Vertebral fractures are sometimes treated with vertebroplasty or kyphoplasty.
Calcium, vitamin D, exercise, and fall prevention support drug treatment; our article on management of osteoporosis with supplements covers that side. For a look at where therapy is heading, see current strategies for osteoporosis and fractures.
Key Takeaways
- M80 is the ICD-10 category for osteoporosis with a current pathological fracture.
- In ICD-10-CM, the code specifies osteoporosis type, fracture site, side, and encounter.
- Use M81 when there is no current fracture, and Z87.310 for a healed osteoporotic fracture history.
- Good documentation of site, mechanism, and encounter type makes accurate coding possible.
Frequently Asked Questions
What is the ICD-10 code for osteoporosis with a vertebral compression fracture?
For age-related osteoporosis, the code is M80.08XA at the initial encounter. The “X” is a placeholder because vertebrae have no laterality, and the final letter changes to D, G, K, P, or S for later encounters.
Can I use M80 if the fracture happened after a fall?
Yes, if the fall was minor and would not normally break healthy bone, such as a fall from standing height. ICD-10-CM guidelines direct coders to use M80 for a patient with known osteoporosis in that situation.
What is the difference between M80.0 and M80.8?
M80.0 is for age-related osteoporosis, including postmenopausal osteoporosis. M80.8 is for other types, such as drug-induced or disuse osteoporosis, where a specific secondary cause is documented.
Should I code M81 and Z87.310 after the fracture heals?
Once the fracture has healed and active and follow-up fracture care has ended, M81 with Z87.310 is generally appropriate. During follow-up for the fracture itself, stay with M80 and the correct subsequent-encounter 7th character.
