Tabular list notes for M80.039K
The tabular list has no notes on M80.039K itself; the notes below apply from its parent headings.
Inherited from M80 (Osteoporosis with current pathological fracture)
- Includes
- osteoporosis with current fragility fracture
- Excludes1 (never coded together)
- collapsed vertebra NOS (M48.5)
- pathological fracture NOS (M84.4)
- wedging of vertebra NOS (M48.5)
- Excludes2 (not part of this condition, may be coded together)
- personal history of (healed) osteoporosis fracture (Z87.310)
- Use additional code
- code to identify major osseous defect, if applicable (M89.7-)
Inherited from M80.0 (Age-related osteoporosis with current pathological fracture)
- Inclusion terms
- Involutional osteoporosis with current pathological fracture
- Osteoporosis NOS with current pathological fracture
- Postmenopausal osteoporosis with current pathological fracture
- Senile osteoporosis with current pathological fracture
Inherited from M80.03 (Age-related osteoporosis with current pathological fracture, forearm)
- Inclusion terms
- Age-related osteoporosis with current pathological fracture of wrist
The 7th character K means “subsequent encounter for fracture with nonunion”, as defined at M80. The same injury coded for a later encounter uses a different 7th character, so check each encounter.
MS-DRG grouping when M80.039K is the principal diagnosis
The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for M80.039K shows the full grouping logic.
CC/MCC status and inpatient edits
As a secondary diagnosis, M80.039K is a CC under MS-DRG v44, unless the principal diagnosis is one of the 5,561 codes in its exclusion list. Check M80.039K against a principal diagnosis.
- Present on admission: exempt from POA indicator reporting (FY2027 exempt list).
- Medicare Code Editor: age conflict: adult diagnosis (age 15 to 124); unspecified code where a laterality-specific code exists.
CMS-HCC V28 risk adjustment
M80.039K does not map to a payment HCC in the PY2027 CMS-HCC V28 model, so on its own it does not change a Medicare Advantage risk score.
LCD billing and coding articles that list M80.039K
4 current Medicare billing and coding articles list M80.039K among the diagnoses that support medical necessity for the services they cover.
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Frequently asked questions
What does ICD-10-CM M80.039K mean?
M80.039K means age-related osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with nonunion. It is one of 25 billable codes under M80, osteoporosis with current pathological fracture.
Which MS-DRG does M80.039K group to?
As the principal diagnosis, M80.039K groups to MS-DRG 564 Other Musculoskeletal System and Connective Tissue Diagnoses with MCC, MS-DRG 565 Other Musculoskeletal System and Connective Tissue Diagnoses with CC, MS-DRG 566 Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCC (MDC 08 MDC 08: Diseases and Disorders of the Musculoskeletal System and Connective Tissue) under MS-DRG v44, before procedures and secondary diagnoses are applied.
Is M80.039K a CC or MCC?
M80.039K is a CC under MS-DRG v44; 5,561 principal diagnoses exclude it.
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- ICD-10-CM FY2027 tabular order file (category titles)Version FY2027 · effective 2026-10-01 · file icd10cm_order_2027.txtSHA-256 38981fb2c1226e2b…
- ICD-10-CM FY2027 tabular list (chapter titles and ranges)Version FY2027 · effective 2026-10-01 · file 2027-code-tables-tabular-index.zipSHA-256 37baa476323714be…
- ICD-10-CM FY2027 code descriptions addenda (codes added, deleted and revised)Version FY2027 · effective 2026-10-01 · file icd10cm_codes_addenda_2027.txtSHA-256 cfba025073235af4…
- ICD-10 MS-DRG Definitions Manual v44 (text)Version v44 · effective 2026-10-01 · file fy2027-fr-icd10-ms-drg-definitions-manual-files-v44.zipSHA-256 ae4f6c11727fe91f…
- IPPS FY2027 Tables 6A-6K: new, invalid and revised ICD-10-CM/PCS codes, CC/MCC list changes and CC exclusionsVersion FY2027 (final rule; not reissued by CN3) · effective 2026-10-01 · file fy2027-ipps-fr-tables-6a-6k.zipSHA-256 ca0af87b0869a405…
- ICD-10-CM FY2027 POA-exempt codes (full list, additions, deletions and revisions)Version FY2027 · effective 2026-10-01 · file 2027-poa-exempt-codes.zipSHA-256 03f55091045024d0…
- ICD-10-CM to CMS-HCC V28 mappings, payment year 2027 initialVersion PY2027 initial ICD-10-CM mappings (dates of service 2026) · effective 2027-01-01 · file 2027 Initial ICD-10-CM Mappings.csvSHA-256 9c260b06d0dd2806…
- Medicare Coverage Database, current Billing and Coding Articles exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file article.csvSHA-256 5e95c4a8ac3664be…
Disclaimer
The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.