2026 ICD-10-CM Diagnosis Code M80.031AAge-related osteoporosis with current pathological fracture, right forearm, initial encounter for fracture
ICD-10-CM Codes›M00–M99›M80-M85›M80
- Billable — Valid for Submission
- 7th Character A — Initial Encounter
- Chronic Condition
M80.031A is a billable ICD-10-CM diagnosis code for age-related osteoporosis with current pathological fracture, right forearm, initial encounter for fracture. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 542 through 544. The code is restricted by the Medicare Code Editor to adult patients (age 15 through 124). Coders also document this condition as pathological fracture of radius. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Osteoporosis; and Pathological fracture, initial encounter.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for M80.031A.
Quality Payment Program MeasuresBilling
Medicare quality measures that can apply when M80.031A is part of the patient record.
Communication with the Physician or Other Clinician Managing On-Going Care Post-Fracture for Men and Women Aged 50 Years and Older
High Priority: YES
Measure Type: Process
Submission Methods: Claims, Registry
Description: Percentage of patients aged 50 years and older treated for a fracture with documentation of communication, between the physician treating the fracture and the physician or other clinician managing the patient's on-going care, that a fracture occurred and that the patient was or should be considered for osteoporosis treatment or testing. This measure is submitted by the physician who treats the fracture and who therefore is held accountable for the communication.
Osteoporosis Management in Women Who Had a Fracture
High Priority: NO
Measure Type: Process
Submission Methods: Claims, Registry
Description: The 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.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Pathological fracture of radius
- Pathological fracture of right radius
- Pathological fracture of right radius due to osteoporosis
- Pathological fracture of right ulna
- Pathological fracture of right ulna due to osteoporosis
- Pathological fracture of ulna
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Arm Injuries and Disorders
Of the 206 bones in your body, three of them are in your arm: the humerus, radius, and ulna. Your arms are also made up of muscles, joints, tendons, and other connective tissue. Injuries to any of these parts of the arm can occur during sports, a fall, or an accident.
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Convert M80.031A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M80.031AOverview
Is M80.031A a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report age-related osteoporosis with current pathological fracture, right forearm, initial encounter for fracture on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in M80.031A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for age-related osteoporosis with current pathological fracture, right forearm, such as an emergency visit or first evaluation.
What MS-DRG does M80.031A group to?
When age-related osteoporosis with current pathological fracture, right forearm, initial encounter for fracture is the principal diagnosis on an inpatient stay, it groups to MS-DRG 542, 543, 544, with relative weights from 0.7546 to 1.7665 depending on complications. Higher weights mean higher Medicare reimbursement.
Who can M80.031A be reported for?
The Medicare Code Editor checks age-related osteoporosis with current pathological fracture, right forearm, initial encounter for fracture against patient demographics: this code is intended for adult patients (age 15 through 124). Claims outside these limits are flagged as inconsistent.
What is the ICD-9 equivalent of M80.031A?
Under the General Equivalence Mappings, age-related osteoporosis with current pathological fracture, right forearm, initial encounter for fracture converts to ICD-9-CM 733.12 (path fx dstl radius ulna). The mapping is approximate, so confirm the match fits the documentation.
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.
