2024 ICD-10-CM Diagnosis Code M80.041A

Age-related osteoporosis with current pathological fracture, right hand, initial encounter for fracture

ICD-10-CM Code:
M80.041A
ICD-10 Code for:
Age-rel osteopor w current path fracture, right hand, init
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Chronic
Code Navigator:

Code Classification

  • Diseases of the musculoskeletal system and connective tissue
    (M00–M99)
    • Disorders of bone density and structure
      (M80-M85)
      • Osteoporosis with current pathological fracture
        (M80)

M80.041A is a billable diagnosis code used to specify a medical diagnosis of age-related osteoporosis with current pathological fracture, right hand, initial encounter for fracture. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

The code M80.041A is applicable to adult patients aged 15 through 124 years inclusive. It is clinically and virtually impossible to use this code on a patient outside the stated age range.

M80.041A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like age-related osteoporosis with current pathological fracture right hand for fracture. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.

The code is linked to some Quality Measures as part of Medicare's Quality Payment Program (QPP). When this code is used as part of a patient's medical record the following Quality Measures might apply: Osteoporosis Management In Women Who Had A Fracture.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Pathological fracture - hand
  • Pathological fracture of right hand
  • Pathological fracture of right hand due to osteoporosis

Clinical Classification

Clinical CategoryCCSR Category CodeInpatient Default CCSROutpatient Default CCSR
OsteoporosisMUS013Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Pathological fracture, initial encounterMUS014N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

  • Adult diagnoses - The Medicare Code Editor detects inconsistencies in adult cases by checking a patient's age and any diagnosis on the patient's record. The adult code edits apply to patients age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).

Convert M80.041A to ICD-9-CM

  • ICD-9-CM Code: 733.19 - Path fx oth specif site
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Quality Payment Program Measures

When code M80.041A is part of the patient's diagnoses the following Quality Measures apply and affect reimbursement. The objective of Medicare's Quality Measures is to improve patient care by making it more: effective, safe, efficient, patient-centered and equitable.

Quality Measure Description Quality Domain Measure Type High Priority Submission Methods
Osteoporosis Management in Women Who Had a FractureThe percentage of women 50-85 years of age who suffered a fracture and who had either a bone mineral density (BMD) test or prescription for a drug to treat osteoporosis in the six months after the fracture.Effective Clinical CareProcessNOClaims, Registry

Patient Education


Fractures

A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open or compound fracture. Fractures commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the bone.

Symptoms of a fracture are:

  • Intense pain
  • Deformity - the limb looks out of place
  • Swelling, bruising, or tenderness around the injury
  • Numbness and tingling
  • Problems moving a limb

You need to get medical care right away for any fracture. An x-ray can tell if your bone is broken. You may need to wear a cast or splint. Sometimes you need surgery to put in plates, pins or screws to keep the bone in place.


[Learn More in MedlinePlus]

Hand Injuries and Disorders

No matter how old you are or what you do for a living, you are always using your hands. When there is something wrong with them, you may not be able to do your regular activities.

Hand problems include :

  • Carpal tunnel syndrome - compression of a nerve as it goes through the wrist, often making your fingers feel numb
  • Injuries that result in fractures (broken bones), ruptured ligaments and dislocations
  • Osteoarthritis - wear-and-tear arthritis, which can also cause deformity
  • Tendinitis - irritation of the tendons
  • Disorders and injuries of your fingers and thumb

[Learn More in MedlinePlus]

Osteoporosis

Osteoporosis is a disease that thins and weakens the bones. Your bones become fragile and fracture (break) easily, especially the bones in the hip, spine, and wrist. In the United States, millions of people either already have osteoporosis or are at high risk due to low bone mass.

Anyone can develop osteoporosis, but it is more common in older women. Risk factors include:

  • Getting older
  • Being small and thin
  • Having a family history of osteoporosis
  • Taking certain medicines
  • Being a white or Asian woman
  • Having low bone density

Osteoporosis is a silent disease. You might not know you have it until you break a bone. A bone mineral density test is the best way to check your bone health.

To keep bones strong, eat a diet rich in calcium and vitamin D, exercise, and do not smoke. If needed, medicines can also help. It is also important to try to avoid falling down. Falls are the number one cause of fractures in older adults.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.