Valid for Submission
M80.059D is a billable diagnosis code used to specify a medical diagnosis of age-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with routine healing. The code M80.059D is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
The ICD-10-CM code M80.059D might also be used to specify conditions or terms like pathological fracture of femur due to osteoporosis, pathological fracture of neck of femur associated with osteoporosis, pathological fracture of proximal femur due to osteoporosis or stress fracture of neck of femur.
The code M80.059D 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.
M80.059D is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like age-related osteoporosis with current pathological fracture unspecified femur for fracture with routine healing. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.
Unspecified diagnosis codes like M80.059D are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Pathological fracture of femur due to osteoporosis
- Pathological fracture of neck of femur associated with osteoporosis
- Pathological fracture of proximal femur due to osteoporosis
- Stress fracture of neck of femur
Diagnostic Related Groups - MS-DRG Mapping
|MS-DRG||MS-DRG Title||MCD||Relative Weight|
|559||AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC||08||1.8679|
|560||AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC||08||1.0764|
|561||AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC||08||0.7911|
The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.
Convert M80.059D to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code M80.059D its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
Information for Patients
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.
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Leg Injuries and Disorders
Your legs are made up of bones, blood vessels, muscles, and other connective tissue. They are important for motion and standing. Playing sports, running, falling, or having an accident can damage your legs. Common leg injuries include sprains and strains, joint dislocations, and fractures (broken bones).
These injuries can affect the entire leg, or just the foot, ankle, knee, or hip. Certain diseases also lead to leg problems. For example, knee osteoarthritis, common in older people, can cause pain and limited motion. Problems in your veins in your legs can lead to varicose veins or deep vein thrombosis.
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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
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