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ICD-10-CM M80.88XG: Other osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with delayed healing

M80.88XG is the billable ICD-10-CM code for other osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with delayed healing, in category M80 (Osteoporosis with current pathological fracture) of the Disorders of bone density and structure section. As a principal diagnosis it 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). 11 LCD billing and coding articles list it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
M80.88XG
billable FY2027 ICD-10-CM code
Category
M80 Osteoporosis with current pathological fracture
Chapter
13: Diseases of the musculoskeletal system and connective tissue (M00-M99)
CC/MCC (MS-DRG v44)
Neither
CMS-HCC V28
Not mapped
POA reporting
Exempt

Tabular list notes for M80.88XG

The tabular list has no notes on M80.88XG 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 M80.8 (Other osteoporosis with current pathological fracture)

Inclusion terms
  • Drug-induced osteoporosis with current pathological fracture
  • Idiopathic osteoporosis with current pathological fracture
  • Osteoporosis of disuse with current pathological fracture
  • Postoophorectomy osteoporosis with current pathological fracture
  • Postsurgical malabsorption osteoporosis with current pathological fracture
  • Post-traumatic osteoporosis with current pathological fracture
Use additional code
  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

The 7th character G means “subsequent encounter for fracture with delayed healing”, 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 M80.88XG is the principal diagnosis

MS-DRG v44 groups for M80.88XG as principal diagnosis
MDCMS-DRGs
08 MDC 08: Diseases and Disorders of the Musculoskeletal System and Connective Tissue559560561

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for M80.88XG shows the full grouping logic.

CC/MCC status and inpatient edits

M80.88XG 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 M80.88XG against a principal diagnosis.

  • Present on admission: exempt from POA indicator reporting (FY2027 exempt list).

CMS-HCC V28 risk adjustment

M80.88XG 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 M80.88XG

11 current Medicare billing and coding articles list M80.88XG among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM M80.88XG mean?

M80.88XG means other osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with delayed healing. It is one of 25 billable codes under M80, osteoporosis with current pathological fracture.

Which MS-DRG does M80.88XG group to?

As the principal diagnosis, M80.88XG 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.

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.