M80.0B1AAge-related osteoporosis with current pathological fracture, right pelvis, initial encounter for fracture

M80.0B1A is the ICD-10-CM diagnosis code for age-related osteoporosis with current pathological fracture, right pelvis, 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 521 (Hip Replacement with Principal Diagnosis of Hip Fracture with MCC, relative weight 2.8515), DRG 522 (Hip Replacement with Principal Diagnosis of Hip Fracture without MCC, relative weight 2.1158), 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) and DRG 544 (Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy without CC/MCC, relative weight 0.7406), in MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue), 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 was added in FY2024, effective October 1, 2023.