ICD-10 Coding for History of Osteoporosis(M80.0, M81.0, Z87.310)
Complete ICD-10-CM coding and documentation guide for History of Osteoporosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Osteoporosis
M80-M81Primary Range
Osteoporosis with or without current pathological fracture
This range includes codes for osteoporosis with and without current fractures, essential for accurate documentation and coding.
Personal history of osteoporosis
This code is used for patients with a history of osteoporosis but no current active management or fracture.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M80.0 | Age-related osteoporosis with current pathological fracture | Use when a patient with osteoporosis presents with a fracture due to minor trauma. |
|
| M81.0 | Age-related osteoporosis without current pathological fracture | Use when a patient has osteoporosis but no current fracture. |
|
| Z87.310 | Personal history of osteoporosis | Use for patients with a history of osteoporosis who are not currently being treated for it. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for history of osteoporosis
Essential facts and insights about History of Osteoporosis
Primary ICD-10-CM Codes for history of osteoporosis
Decision Criteria
clinical Criteria
- Presence of fracture in a patient with known osteoporosis
Applicable To
- Osteoporosis with fracture
Excludes
- Traumatic fracture
Clinical Validation Requirements
- Documented fracture in the presence of osteoporosis
- DEXA T-score ≤-2.5
Code-Specific Risks
- Misclassifying traumatic fractures as pathological
Coding Notes
- Ensure documentation specifies 'pathological' to differentiate from traumatic fractures.
M81.0 - Age-related osteoporosis without current pathological fracture
Use when a patient has osteoporosis but no current fracture.
Applicable To
- Osteoporosis without fracture
Excludes
- Osteopenia
Clinical Validation Requirements
- DEXA T-score ≤-2.5
- No current fracture
Coding Notes
Ensure T-score documentation supports osteoporosis diagnosis.
Z87.310 - Personal history of osteoporosis
Use for patients with a history of osteoporosis who are not currently being treated for it.
Applicable To
- Resolved osteoporosis
Excludes
- Current osteoporosis
Clinical Validation Requirements
- Documented history of osteoporosis
- No active management or current fracture
Coding Notes
Ensure documentation clearly states the condition is historical.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Personal history of osteoporosis
Z87.310Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting History of Osteoporosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M80.0.
Impact
Clinical: Inaccurate diagnosis of osteoporosis., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always include DEXA results in patient records.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Verify T-score to ensure correct diagnosis of osteoporosis.
Impact
Reimbursement: May affect DRG assignment and reimbursement., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Misleading clinical data.
Mitigation Strategy
Ensure documentation specifies 'pathological' for fractures in osteoporosis.
Impact
High risk of incorrect coding for fractures in osteoporosis patients.
Mitigation Strategy
Implement regular training on distinguishing pathological vs. traumatic fractures.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for History of Osteoporosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Osteoporosis
Use these documentation templates to ensure complete and accurate documentation for History of Osteoporosis. These templates include all required elements for proper coding and billing.
Follow-up visit for osteoporosis
Specialty: EndocrinologyRequired Elements
- Patient history
- Current treatment
- DEXA results
- Fracture status
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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