2026 ICD-10-CM Diagnosis Code M80.821POther osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with malunion
ICD-10-CM Codes›M00–M99›M80-M85›M80
- Billable — Valid for Submission
- POA Exempt
- 7th Character P — Subsequent, Malunion
- Chronic Condition
M80.821P is a billable ICD-10-CM diagnosis code for other osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with malunion. The 7th character P reports a subsequent encounter for a fracture that has healed in a faulty position, called a malunion. 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 exempt from POA reporting. Coders also document this condition as pathological fracture - upper arm. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pathological fracture, subsequent encounter.
Code Identity
Code Classification
Present on Admission (POA)Billing
M80.821P 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 - upper arm
- Pathological fracture of right humerus
- Pathological fracture of right humerus due to osteoporosis
- Pathological fracture of right humerus due to secondary osteoporosis
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 M80.821P to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M80.821POverview
Is M80.821P a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report other osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with malunion on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character P in M80.821P mean?
The final character P reports a subsequent encounter where the other osteoporosis with current pathological fracture, right humerus has healed in a faulty position, called a malunion.
What MS-DRG does M80.821P group to?
When other osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with malunion 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.
Is M80.821P 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 other osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with malunion on inpatient claims.
What is the ICD-9 equivalent of M80.821P?
Under the General Equivalence Mappings, other osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with malunion converts to ICD-9-CM 733.81 (malunion of fracture). 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.
