M80.862A — Other osteoporosis with current pathological fracture, left lower leg, initial encounter for fracture
Is M80.862A billable?
Yes — M80.862A is billable for FY2027. M80.862A is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. M80.862A may be submitted for encounters from October 1, 2026 through September 30, 2027.
M80.862A at a glance
| Code | M80.862A |
|---|---|
| Description | Other osteoporosis with current pathological fracture, left lower leg, 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 M80.862A?
In M80.862A, the 7th character A means initial encounter for fracture. The 7th character is required for M80.862A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does M80.862A group to?
M80.862A 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, M80.862A is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is M80.862A listed in the Alphabetic Index?
The Alphabetic Index lists these routes under M80.86, the nearest indexed parent of M80.862A. Use them to find the family, then select the specific code.
- Osteoporosis › disuse › with current pathological fracture › fibula (female) (male)
- Osteoporosis › disuse › with current pathological fracture › tibia (female) (male)
- Osteoporosis › specified type NEC › with pathological fracture › fibula (female) (male)
- Osteoporosis › specified type NEC › with pathological fracture › tibia (female) (male)
Excludes1 — never code together — inherited from M80
The conditions below can never be reported together with M80.862A 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 M80.862A to fully describe the condition. M80.862A is sequenced first.
- code to identify major osseous defect, if applicable (M89.7-)
Use additional code — inherited from M80.8
Report an additional code alongside M80.862A to fully describe the condition. M80.862A is sequenced first.
- code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M80.862A, but a patient may have both at the same time. When documentation supports it, M80.862A 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 M80.862A, but a patient may have both at the same time. When documentation supports it, M80.862A and the excluded code may both be reported.
- personal history of (healed) osteoporosis fracture (Z87.310)
How long has M80.862A existed?
M80.862A 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.