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ICD-10 Guide
ICD-10 CodesM81.0

M81.0

Billable

Age-related osteoporosis without current pathological fracture

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M81.0 is a billable code used to indicate a diagnosis of age-related osteoporosis without current pathological fracture.

Key Diagnostic Point:

Age-related osteoporosis is a condition characterized by a decrease in bone density and quality, primarily due to the aging process. This condition is prevalent among older adults, particularly postmenopausal women, and is associated with an increased risk of fractures. Osteoporosis occurs when the rate of bone resorption exceeds the rate of bone formation, leading to a reduction in bone mass and structural deterioration of bone tissue. Patients with M81.0 do not currently exhibit pathological fractures, which distinguishes this code from other osteoporosis-related codes that may involve recent fractures. Diagnosis typically involves clinical evaluation, bone mineral density (BMD) testing, and assessment of risk factors such as family history, lifestyle, and previous fractures. Management strategies may include lifestyle modifications, dietary changes, and pharmacological interventions aimed at improving bone density and reducing fracture risk. Regular monitoring and follow-up are essential to assess treatment efficacy and adjust management plans accordingly.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between age-related osteoporosis and other types of osteoporosis.
  • Understanding the absence of current pathological fractures in coding.
  • Interpreting bone density test results and their implications for coding.
  • Navigating documentation requirements for various specialties.

Audit Risk Factors

  • Inadequate documentation of bone density test results.
  • Failure to specify the absence of current fractures.
  • Misclassification of osteoporosis type.
  • Lack of comprehensive patient history.

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed history of bone health, including previous fractures and family history of osteoporosis.

Common Clinical Scenarios

Patients presenting with low bone density results and risk factors for osteoporosis.

Billing Considerations

Endocrinologists should ensure that all relevant lab results and treatment plans are documented to support the diagnosis.

Orthopedics

Documentation Requirements

Documentation of any previous fractures, current bone health assessments, and treatment plans.

Common Clinical Scenarios

Patients with a history of falls or fractures being evaluated for osteoporosis.

Billing Considerations

Orthopedic surgeons must differentiate between fractures due to osteoporosis and those from other causes.

Coding Guidelines

Inclusion Criteria

Use M81.0 When
  • According to ICD
  • 10 guidelines, M81
  • 0 should be used when there is clear documentation of age
  • related osteoporosis without any current pathological fractures
  • It is essential to ensure that the diagnosis is supported by appropriate clinical documentation and diagnostic tests

Exclusion Criteria

Do NOT use M81.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76977CPT Code

Bone density measurement

Clinical Scenario

Used to assess bone density in patients suspected of having osteoporosis.

Documentation Requirements

Must include the reason for the test and any relevant patient history.

Specialty Considerations

Endocrinologists and primary care physicians should document the clinical rationale for testing.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of osteoporosis types, improving the accuracy of patient records and treatment plans. M81.0 provides a clear distinction for age-related osteoporosis without fractures, enhancing clinical understanding and management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of osteoporosis types, improving the accuracy of patient records and treatment plans. M81.0 provides a clear distinction for age-related osteoporosis without fractures, enhancing clinical understanding and management.

Reimbursement & Billing Impact

reimbursement and quality of care.

Resources

Clinical References

  • •
    National Osteoporosis Foundation

Coding & Billing References

  • •
    National Osteoporosis Foundation

Frequently Asked Questions

What is the difference between M81.0 and M80.0?

M81.0 refers to age-related osteoporosis without current pathological fractures, while M80.0 includes patients who have experienced recent fractures. Accurate coding depends on the presence or absence of fractures.