2026 ICD-10-CM Diagnosis Code M80.012KAge-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with nonunion

ICD-10-CM Codes›M00–M99›M80-M85›M80

ICD-10-CM M80.012K
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

M80.012K is a billable ICD-10-CM diagnosis code for age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with nonunion. The 7th character K reports a subsequent encounter for a fracture that has failed to heal, called a nonunion. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 564 through 566. The code is restricted by the Medicare Code Editor to adult patients (age 15 through 124) and exempt from POA reporting. Coders also document this condition as pathological fracture of clavicle. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pathological fracture, subsequent encounter.

Code Identity

ICD-10-CM Code
M80.012K
Billable Status
Yes — Valid for Submission
Code Describes
Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with nonunion
Short Description
Age-rel osteopor w crnt path fx, l shldr, 7thK
Parent Code
M80.012
Age-related osteoporosis with current pathological fracture, left shoulder

Code Classification

ChapterM00–M99Diseases of the musculoskeletal system and connective tissue
SectionM80-M85Disorders of bone density and structure
CategoryM80Osteoporosis with current pathological fracture
This CodeM80.012KAge-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with nonunion

Code EditsBilling

Medicare Code Editor checks that affect claim validity for M80.012K.

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)Billing

M80.012K is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Pathological fracture of clavicle
  • Pathological fracture of left clavicle
  • Pathological fracture of left clavicle due to osteoporosis
  • Pathological fracture of left scapula
  • Pathological fracture of left scapula due to osteoporosis
  • Pathological fracture of scapula

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MUS015
Pathological fracture, subsequent encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Fractures

A fracture is a break in a bone. Fractures are usually caused by injuries. Since they can sometimes be serious, it's important to get medical care right away if you think you have a fracture.

The full article covers:

  • What is a fracture?
  • What are the different types of fractures?
  • What causes fractures?
  • What are the symptoms of a fracture?
  • How are fractures diagnosed?
  • What are the treatments for fractures?
  • Can fractures be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert M80.012K to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
733.82 Nonunion of fracture
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About M80.012KOverview

Is M80.012K a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with nonunion on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character K in M80.012K mean?

The final character K reports a subsequent encounter where the age-related osteoporosis with current pathological fracture, left shoulder has failed to heal, called a nonunion.

What MS-DRG does M80.012K group to?

When age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with nonunion is the principal diagnosis on an inpatient stay, it groups to MS-DRG 564, 565, 566, with relative weights from 0.7493 to 1.5436 depending on complications. Higher weights mean higher Medicare reimbursement.

Who can M80.012K be reported for?

The Medicare Code Editor checks age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with nonunion against patient demographics: this code is intended for adult patients (age 15 through 124). Claims outside these limits are flagged as inconsistent.

Is M80.012K exempt from POA reporting?

Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with nonunion on inpatient claims.

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.