ICD-10 M81 Osteoporosis without current pathological fracture
By Judy Monestime bio
Chapter 13 Diseases of the musculoskeletal system and connective tissue (M00-M99); M stands for Musculoskeletal, contains many more subchapters, categories, and codes than ICD-9-CM. Rather than having just four subchapters grouping many conditions together, ICD-10-CM organizes the musculoskeletal system and connective tissue in the following blocks:
M00-M02 Infectious arthropathies
M05-M14 Inflammatory polyarthropathies
M15-M19 Osteoarthritis
M20-M25 Other joint disorders
M26-M27 Dentofacial anomalies [including malocclusion] and other disorders of jaw
M30-M36 Systemic connective tissue disorders
M40-M43 Deforming dorsopathies
M45-M49 Spondylopathies
M50-M54 Other dorsopathies
M60-M63 Disorders of muscles
M65-M67 Disorders of synovium and tendon
M70-M79 Other soft tissue disorders
M80-M85 Disorders of bone density and structure
M86-M90 Other osteopathies
M91-M94 Chondropathies
M95 Other disorders of the musculoskeletal system and connective tissue
M96 Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified
M99 Biomechanical lesions, not elsewhere classified
Almost every code in Chapter 13 of ICD-10-CM has been expanded in some way with the expansion including very specific sites as well as laterality. Category M80-M81 in ICD-10-CM classifies the type of osteoporosis. The condition of strictly osteoporosis without pathological fracture is classified with codes in category M81. The official ICD-10-CM Coding Guidelines provides plenty of instructions. Let’s review the guidelines for osteoporosis without pathological fracture:
Category M81‑Osteoporosis without current pathological fracture‑ is for use for patients with osteoporosis who do not currently have a pathologic fracture due to the osteoporosis, even if they have had a fracture in the past. For patients with a history of osteoporosis fractures, status code Z87.310, Personal history of (healed) osteoporosis fracture, should follow the code from M81.
Coders are instructed to report codes from category M81 for osteoporosis without pathological fracture. Report these codes for patients with osteoporosis who do not currently have a pathologic fracture due to osteoporosis even if they have had one in the past. Site is not a component of the codes under this category. The type of osteoporosis is identified at the fourth character level:
M81.0 Age-related osteoporosis without current pathological fracture
M81.6 Localized osteoporosis [Lequesne]
M81.8 Other osteoporosis without current pathological fracture
There is a “use additional code” note that appears at the heading of M81 that reminds coders to use a code for any major osseous defect (M89.7-) or personal history of (healed) osteoporosis fracture (Z87.310.) if applicable. For code M81.8 coders are instructed to “use additional code” for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5).
Let’s practice! How do you code the following?
Postmenopausal osteoporosis in a 65-year-old female with a history of healed osteoporotic fracture of the ankle.
M81.0 Age-related osteoporosis without current pathological fracture
Z87.310, Personal history of (healed) osteoporosis fracture
Rationale: The personal history codes include expanded codes to identify past conditions. The note at category M81 states: Use additional code to identify personal history of (healed) osteoporosis fracture, if applicable (Z87.310). The documentation for the fracture states that it is healed and not causing any complications.
Judy Monestime, MBA, CDIP, CPC, is an AHIMA-approved ICD-10-CM/PCS trainer.
