ICD-10-CM 2027 diagnosis code
M80.021AAge-related osteoporosis with current pathological fracture, right humerus, initial encounter for fracture
M80.021A is a valid, billable ICD-10-CM code for age-related osteoporosis with current pathological fracture, right humerus, initial encounter for fracture. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.Short description: Age-rel osteopor w current path fracture, r humerus, init
Code unchanged since ICD-10-CM took effect on October 1, 2015. Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data
About M80.021A
M80.021A is the ICD-10-CM diagnosis code for age-related osteoporosis with current pathological fracture, right humerus, initial encounter for fracture. It belongs to category M80 (osteoporosis with current pathological fracture), block M80-M85 (disorders of bone density and structure) and chapter 13 (diseases of the musculoskeletal system and connective tissue). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.
The 7th character "A" means initial encounter for fracture: use it while the patient is receiving active treatment for the condition.
Use an additional code to identify major osseous defect, if applicable (M89.7-).
As a secondary diagnosis it is a CC (complication or comorbidity), which can move an inpatient stay into the "with CC" MS-DRG of its family, unless the principal diagnosis excludes it.
In MS-DRG v44.0, it is part of the grouping logic for DRG 542 (Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with MCC, relative weight 1.7211), DRG 543 (Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with CC, relative weight 1.006), DRG 544 (Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy without CC/MCC, relative weight 0.7406), DRG 791 (Prematurity with Major Problems, relative weight 4.1075) and DRG 793 (Full Term Neonate with Major Problems, relative weight 4.2195), in MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue) and MDC 15 (Newborns and Other Neonates with Conditions Originating in the Perinatal Period), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.
The Medicare Code Editor expects this diagnosis only for patients age 15 through 124.
It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.
Before ICD-10, this condition was coded in ICD-9-CM as 733.11 (pathologic fracture of humerus).
7th character
Ainitial encounter for fracture
CC/MCC status for this injury by encounter: CC for A, K, P; Neither CC nor MCC for D, G, S.
Other encounter types for M80.021:
Notes that apply from higher levels
Instructions written at a parent level also apply to M80.021A.
› From M80 Osteoporosis with current pathological fracture
Broader instructions also apply from Chapter 13: Diseases of the musculoskeletal system and connective tissue.
MS-DRG v44.0 grouping
All DRGs →Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.
MDC 08 · Diseases and Disorders of the Musculoskeletal System and Connective Tissue
MDC 15 · Newborns and Other Neonates with Conditions Originating in the Perinatal Period
MDC 15 · Newborns and Other Neonates with Conditions Originating in the Perinatal Period
ICD-9-CM equivalent
Converter →- 733.11Pathologic fracture of humerusapproximate
From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.
Code history
- 2016
- 2017
- 2018
- 2019
- 2020
- 2021
- 2022
- 2023
- 2024
- 2025
- 2026
- 2027
- FY2016 (effective 10/1/2015): Added (first year of ICD-10-CM)
- No changes since FY2016.
Common questions about M80.021A
Is M80.021A billable?
- Yes. M80.021A is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).
What does the "A" at the end of M80.021A mean?
- It is the 7th character for initial encounter for fracture. Per the official guidelines, use it while the patient is receiving active treatment for the condition.
Can M80.021A be used as a principal diagnosis?
- Yes. The Medicare Code Editor doesn't restrict M80.021A as a principal diagnosis.
Is M80.021A a CC or MCC?
- M80.021A is a CC (complication or comorbidity) under MS-DRG v44.0, unless excluded by the principal diagnosis.
What DRG does M80.021A group to?
- M80.021A is used in the MS-DRG v44.0 logic for MS-DRG 542 (Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with MCC), MS-DRG 543 (Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with CC), MS-DRG 544 (Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy without CC/MCC), MS-DRG 791 (Prematurity with Major Problems) and MS-DRG 793 (Full Term Neonate with Major Problems). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.
What is the ICD-9 code for M80.021A?
- The CMS General Equivalence Mappings map M80.021A to ICD-9-CM 733.11.