2026 ICD-10-CM Diagnosis Code M80.8B2GOther osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with delayed healing
M80.8B2G is a billable ICD-10-CM diagnosis code for other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with delayed healing. The 7th character G reports a subsequent encounter for a fracture that is healing more slowly than expected. 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, 559 through 561. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pathological fracture, subsequent encounter.
Code Identity
Code Classification
Present on Admission (POA)Billing
M80.8B2G 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 M80.8B2G 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.
Code History & ChangesHistory
Replacement M80.8B2G replaces the following previously assigned code(s):
- M80.8AXG - Other osteopor with current path fracture, other site, 7thG
Questions About M80.8B2GOverview
Is M80.8B2G a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with delayed healing on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character G in M80.8B2G mean?
The final character G reports a subsequent encounter where the other osteoporosis with current pathological fracture, left pelvis is healing more slowly than expected.
What MS-DRG does M80.8B2G group to?
When other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with delayed healing is the principal diagnosis on an inpatient stay, it groups to MS-DRG 521, 522, 559, 560, 561, with relative weights from 0.8039 to 2.8702 depending on complications. Higher weights mean higher Medicare reimbursement.
Is M80.8B2G 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, left pelvis, subsequent encounter for fracture with delayed healing 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.
