2026 ICD-10-CM Diagnosis Code M80.8B1POther osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with malunion

ICD-10-CM Codes›M00–M99›M80-M85›M80

ICD-10-CM M80.8B1P
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

M80.8B1P is a billable ICD-10-CM diagnosis code for other osteoporosis with current pathological fracture, right pelvis, 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 521 through 522, 564 through 566. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pathological fracture, subsequent encounter.

Code Identity

ICD-10-CM Code
M80.8B1P
Billable Status
Yes — Valid for Submission
Code Describes
Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with malunion
Short Description
Other osteopor with current path fx, right pelvis, 7thP
Parent Code
M80.8B1
Other osteoporosis with current pathological fracture, right pelvis

Code Classification

ChapterM00–M99Diseases of the musculoskeletal system and connective tissue
SectionM80-M85Disorders of bone density and structure
CategoryM80Osteoporosis with current pathological fracture
This CodeM80.8B1POther osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with malunion

Present on Admission (POA)Billing

M80.8B1P 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 M80.8B1P 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.

View Measure

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.

View Measure

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

Code History & ChangesHistory

Replacement M80.8B1P replaces the following previously assigned code(s):

  • M80.8AXP - Other osteopor with current path fracture, other site, 7thP
FY 2024AddedAdded to the ICD-10-CM code setEffective October 1, 2023.
FY 2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About M80.8B1POverview

Is M80.8B1P a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report other osteoporosis with current pathological fracture, right pelvis, 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 M80.8B1P mean?

The final character P reports a subsequent encounter where the other osteoporosis with current pathological fracture, right pelvis has healed in a faulty position, called a malunion.

What MS-DRG does M80.8B1P group to?

When other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with malunion is the principal diagnosis on an inpatient stay, it groups to MS-DRG 521, 522, 564, 565, 566, with relative weights from 0.7493 to 2.8702 depending on complications. Higher weights mean higher Medicare reimbursement.

Is M80.8B1P 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 pelvis, subsequent encounter for fracture with malunion 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.