M80.012A — Age-related osteoporosis with current pathological fracture, left shoulder, initial encounter for fracture
Is M80.012A billable?
Yes — M80.012A is billable for FY2027. M80.012A is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. M80.012A may be submitted for encounters from October 1, 2026 through September 30, 2027.
M80.012A at a glance
| Code | M80.012A |
|---|---|
| Description | Age-related osteoporosis with current pathological fracture, left shoulder, initial encounter for fracture |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter for fracture |
What does the 7th character "A" mean in M80.012A?
In M80.012A, the 7th character A means initial encounter for fracture. The 7th character is required for M80.012A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does M80.012A group to?
M80.012A sits in MDC 08 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 542Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with MCCmedical
- 543Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with CCmedical
- 544Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy without CC/MCCmedical
As a secondary diagnosis, M80.012A is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is M80.012A listed in the Alphabetic Index?
The Alphabetic Index lists these routes under M80.01, the nearest indexed parent of M80.012A. Use them to find the family, then select the specific code.
- Osteoporosis › age-related › with current pathologic fracture › clavicle (female) (male)
- Osteoporosis › age-related › with current pathologic fracture › scapula (female) (male)
- Osteoporosis › postmenopausal › with pathological fracture › clavicle (female) (male)
- Osteoporosis › postmenopausal › with pathological fracture › scapula (female) (male)
Excludes1 — never code together — inherited from M80
The conditions below can never be reported together with M80.012A on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Use additional code — inherited from M80
Report an additional code alongside M80.012A to fully describe the condition. M80.012A is sequenced first.
- code to identify major osseous defect, if applicable (M89.7-)
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M80.012A, but a patient may have both at the same time. When documentation supports it, M80.012A and the excluded code may both be reported.
- 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)
Excludes2 — not included here — inherited from M80
The conditions below are not part of M80.012A, but a patient may have both at the same time. When documentation supports it, M80.012A and the excluded code may both be reported.
- personal history of (healed) osteoporosis fracture (Z87.310)
How long has M80.012A existed?
M80.012A has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.