2024 ICD-10-CM Diagnosis Code M80.0AXK
Age-related osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with nonunion
- ICD-10-CM Code:
- M80.0AXK
- ICD-10 Code for:
- Age-rel osteopor with current path fx, other site, 7thK
- Is Billable?
- Yes - Valid for Submission
- Chronic Condition Indicator: [1]
- Chronic
- Code Navigator:
M80.0AXK is a billable diagnosis code used to specify a medical diagnosis of age-related osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with nonunion. 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 is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
The code M80.0AXK 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.
M80.0AXK 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 other site for fracture with nonunion. 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.
Clinical Classification
Clinical Category is Pathological fracture, subsequent encounter
- CCSR Category Code: MUS015
- Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
- Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Replaced Code
This code was replaced in the 2024 ICD-10-CM code set with the code(s) listed below. The National Center for Health Statistics (NCHS) has published an update to the ICD-10-CM diagnosis codes which became effective October 1, 2023. This code was replaced for the FY 2024 (October 1, 2023 - September 30, 2024).
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).
Present on Admission (POA)
M80.0AXK is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
CMS POA Indicator Options and Definitions
POA Indicator | Reason for Code | CMS will pay the CC/MCC DRG? |
---|---|---|
Y | Diagnosis was present at time of inpatient admission. | YES |
N | Diagnosis was not present at time of inpatient admission. | NO |
U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
1 | Unreported/Not used - Exempt from POA reporting. | NO |
Replacement Code
M800AXK replaces the following previously assigned ICD-10-CM code(s):
- M80.00XK - Age-rel osteopor w crnt path fx, unsp site, 7thK
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 - Code Added, effective from 10/1/2020 through 9/30/2021
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.