2027 ICD-10-CM Diagnosis Code M81.8Other osteoporosis without current pathological fracture

ICD-10-CM Codes›M00–M99›M80-M85›M81

ICD-10-CM M81.8
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

M81.8 is a billable ICD-10-CM diagnosis code for other osteoporosis without current pathological fracture. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 553 through 554. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Osteoporosis.

M81.8 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 87 for payment year 2027.

Code Identity

ICD-10-CM Code
M81.8
Billable Status
Yes — Valid for Submission
Code Describes
Other osteoporosis without current pathological fracture
Short Description
Other osteoporosis without current pathological fracture
Same as the full description in the CMS dataset.
Parent Code
Osteoporosis without current pathological fracture

Code Classification

ChapterM00–M99Diseases of the musculoskeletal system and connective tissue
SectionM80-M85Disorders of bone density and structure
CategoryM81Osteoporosis without current pathological fracture
This CodeM81.8Other osteoporosis without current pathological fracture

Medicare Risk Adjustment (HCC)Billing

M81.8 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model, but it maps to payment categories in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
no payment category in the model that pays 100% of MA risk scores
Prior Model (CMS-HCC V24)
Not mapped under V24
this diagnosis newly risk-adjusts under the V28 model
Part D (RxHCC)
RxHCC 87 — Osteoporosis, Vertebral and Pathological Fractures
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Adult idiopathic generalized osteoporosis
  • Astronaut-bone demineralization syndrome
  • Autosomal dominant hypophosphatemic bone disease
  • Chronic kidney disease mineral and bone disorder
  • Disuse osteoporosis
  • Dominant hypophosphatemia with nephrolithiasis and/or osteoporosis
  • Drug-induced osteoporosis
  • Dysplasia with defective mineralization
  • Female athlete triad
  • Idiopathic generalized osteoporosis
  • Idiopathic osteoporosis
  • Idiopathic osteoporosis in pregnancy
  • Juvenile idiopathic generalized osteoporosis
  • Localized disuse osteoporosis
  • LRP5-related primary osteoporosis
  • Osteoporosis and oculocutaneous hypopigmentation syndrome
  • Osteoporosis caused by corticosteroid
  • Osteoporosis caused by ionizing radiation
  • Osteoporosis circumscripta
  • Osteoporosis co-occurrent and due to multiple myeloma
  • Osteoporosis due to and following radiotherapy
  • Osteoporosis due to chronic kidney disease
  • Osteoporosis due to cystic fibrosis
  • Osteoporosis due to endocrine disorder
  • Osteoporosis due to malabsorption
  • Paget's disease of skull
  • Postoophorectomy osteoporosis
  • Post-surgical malabsorption osteoporosis
  • Posttraumatic osteoporosis
  • Premenopausal idiopathic osteoporosis
  • RED-S - relative energy deficiency in sport
  • Regional migrating osteoporosis
  • Regional osteoporosis
  • Secondary generalized osteoporosis
  • Secondary osteoporosis
  • Transient osteoporosis
  • Transient osteoporosis of hip
  • Transient osteoporosis of hip in pregnancy

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to M81.8: its own notes plus those printed at M81 and Chapter 13. A note printed at a category, block or chapter applies to every code under it.

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Drug-induced osteoporosis without current pathological fracture
  • Idiopathic osteoporosis without current pathological fracture
  • Osteoporosis of disuse without current pathological fracture
  • Postoophorectomy osteoporosis without current pathological fracture
  • Postsurgical malabsorption osteoporosis without current pathological fracture
  • Post-traumatic osteoporosis without current pathological fracture

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From M81 Osteoporosis without current pathological fracture applies to 3 codes
  • osteoporosis with current pathological fracture (M80.-)
  • Sudeck's atrophy (M89.0)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Chapter 13 (M00-M99) Diseases of the musculoskeletal system and connective tissue applies to 6,687 codes
  • arthropathic psoriasis (L40.5-)
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • compartment syndrome (traumatic) (T79.A-)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

On M81.8 itself
  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
From M81 Osteoporosis without current pathological fracture applies to 3 codes
  • code to identify:
  • major osseous defect, if applicable (M89.7-)
  • personal history of (healed) osteoporosis fracture, if applicable (Z87.310)

Notes

General instructions on how these codes are used.

From Chapter 13 (M00-M99) Diseases of the musculoskeletal system and connective tissue applies to 6,687 codes
  • Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name M81.8, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming M81.8: they are not reported together with it, unless the two conditions are unrelated.

  • K91.2 Postsurgical malabsorption, not elsewhere classified
    malabsorption osteoporosis, postsurgical (M80.8-, M81.8)

Excludes2 1

These codes carry an Excludes2 note naming M81.8: its condition is not part of those codes, and both may be reported when the patient has both.

  • N99 Intraoperative and postprocedural complications and disorders of genitourinary system, not elsewhere classified
    postoophorectomy osteoporosis without current pathological fracture (M81.8)

Code First 1

These codes say to code first a condition named in the note, and M81.8 is one of the conditions named.

  • M89.7 Major osseous defect
    osteoporosis (M80.-, M81.-) names M81.-, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MUS013
Osteoporosis
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Osteoporosis

Osteoporosis is a disease in which your bones become weak and are likely to fracture (break). The disease can develop when your bone mineral density and bone mass decrease. It can also happen if the structure and strength of your bones change.

The full article covers:

  • What is osteoporosis?
  • What causes osteoporosis?
  • Who is more likely to develop osteoporosis?
  • What are the symptoms of osteoporosis?
  • How is osteoporosis diagnosed?
  • What are the treatments for osteoporosis?
  • Can osteoporosis be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert M81.8 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
733.02 Idiopathic osteoporosis
Approximate The match is approximate rather than exact.
ICD-9-CM
733.03 Disuse osteoporosis
Approximate The match is approximate rather than exact.
ICD-9-CM
733.09 Osteoporosis NEC
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About M81.8Overview

What is the ICD-10 code for other osteoporosis without current pathological fracture?

The ICD-10-CM code for other osteoporosis without current pathological fracture is M81.8 (sometimes written as M818). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is M81.8 (Osteoporosis without current pathological fracture) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report other osteoporosis without current pathological fracture on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does M81.8 group to?

When other osteoporosis without current pathological fracture is the principal diagnosis on an inpatient stay, it groups to MS-DRG 554, 553, with relative weights from 0.8328 to 1.2492 depending on complications. Higher weights mean higher Medicare reimbursement.

Can M81.8 be reported with a code from M80?

Not as a rule. The Excludes1 note at M81, which applies to M81.8, lists "osteoporosis with current pathological fracture (M80.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

Does M81.8 need an additional code?

When the condition applies, yes. The Use Additional Code note reads: code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5). The additional code is reported after M81.8.

Does M81.8 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage: M81.8 maps to no category in the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 87 (Osteoporosis, Vertebral and Pathological Fractures).