Tabular list notes for M80.072S
The tabular list has no notes on M80.072S 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
The 7th character S means “sequela”, 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 M80.072S is the principal diagnosis
The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for M80.072S shows the full grouping logic.
CC/MCC status and inpatient edits
M80.072S is neither a CC nor an MCC under MS-DRG v44, so as a secondary diagnosis it does not raise the MS-DRG severity level. Check M80.072S 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).
CMS-HCC V28 risk adjustment
M80.072S 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 M80.072S
12 current Medicare billing and coding articles list M80.072S among the diagnoses that support medical necessity for the services they cover.
- Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®) and biosimilars A52399
- Billing and Coding: Ibandronate Sodium A52421
- Billing and Coding: Home Health Occupational Therapy A53057
- Billing and Coding: Home Health Physical Therapy A53058
- Billing and Coding: Outpatient Occupational Therapy A53064
- Billing and Coding: Outpatient Physical Therapy A53065
- Billing and Coding: Assays for Vitamins and Metabolic Function A56416
- Billing and Coding: CPT 82306 (descriptor licensed by AMA) A56841
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Frequently asked questions
What does ICD-10-CM M80.072S mean?
M80.072S means age-related osteoporosis with current pathological fracture, left ankle and foot, sequela. It is one of 25 billable codes under M80, osteoporosis with current pathological fracture.
Which MS-DRG does M80.072S group to?
As the principal diagnosis, M80.072S groups to MS-DRG 559 Aftercare, Musculoskeletal System and Connective Tissue with MCC, MS-DRG 560 Aftercare, Musculoskeletal System and Connective Tissue with CC, MS-DRG 561 Aftercare, Musculoskeletal System and Connective Tissue 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.
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.