2026 ICD-10-CM Diagnosis Code M80.0B9SAge-related osteoporosis with current pathological fracture, unspecified pelvis, sequela
ICD-10-CM Codes›M00–M99›M80-M85›M80
- Billable — Valid for Submission
- POA Exempt
- 7th Character S — Sequela
- Chronic Condition
M80.0B9S is a billable ICD-10-CM diagnosis code for age-related osteoporosis with current pathological fracture, unspecified pelvis, sequela. The 7th character S marks it as a sequela code, which reports a problem that remains after the original condition has resolved. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 559 through 561. The code is restricted by the Medicare Code Editor to adult patients (age 15 through 124) and exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pathological, stress and atypical fractures, sequela.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for M80.0B9S.
Present on Admission (POA)Billing
M80.0B9S is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Quality Payment Program MeasuresBilling
Medicare quality measures that can apply when M80.0B9S 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.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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.
Code History & ChangesHistory
Replacement M80.0B9S replaces the following previously assigned code(s):
- M80.0AXS - Age-rel osteopor with current path fx, other site, sequela
Questions About M80.0B9SOverview
Is M80.0B9S a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report age-related osteoporosis with current pathological fracture, unspecified pelvis, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in M80.0B9S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the age-related osteoporosis with current pathological fracture, unspecified pelvis itself has resolved, not the original event.
What MS-DRG does M80.0B9S group to?
When age-related osteoporosis with current pathological fracture, unspecified pelvis, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 559, 560, 561, with relative weights from 0.8039 to 1.8649 depending on complications. Higher weights mean higher Medicare reimbursement.
Who can M80.0B9S be reported for?
The Medicare Code Editor checks age-related osteoporosis with current pathological fracture, unspecified pelvis, sequela against patient demographics: this code is intended for adult patients (age 15 through 124). Claims outside these limits are flagged as inconsistent.
Is M80.0B9S 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, unspecified pelvis, sequela 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.
