2026 ICD-10-CM Diagnosis Code M80.821SOther osteoporosis with current pathological fracture, right humerus, sequela
ICD-10-CM Codes›M00–M99›M80-M85›M80
- Billable — Valid for Submission
- POA Exempt
- 7th Character S — Sequela
- Chronic Condition
M80.821S is a billable ICD-10-CM diagnosis code for other osteoporosis with current pathological fracture, right humerus, 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 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, stress and atypical fractures, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
M80.821S 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.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert M80.821S to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M80.821SOverview
Is M80.821S a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report other osteoporosis with current pathological fracture, right humerus, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in M80.821S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the other osteoporosis with current pathological fracture, right humerus itself has resolved, not the original event.
What MS-DRG does M80.821S group to?
When other osteoporosis with current pathological fracture, right humerus, 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.
Is M80.821S 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, sequela on inpatient claims.
What is the ICD-9 equivalent of M80.821S?
Under the General Equivalence Mappings, other osteoporosis with current pathological fracture, right humerus, sequela converts to ICD-9-CM 905.2 (late effect arm fx). 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.
