ICD-10 Coding for Metabolic Bone Disease(M80.0, E83.5)
Complete ICD-10-CM coding and documentation guide for Metabolic Bone Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Metabolic Bone Disease
M80-M81Primary Range
Osteoporosis with or without current pathological fracture
Primary range for osteoporosis-related metabolic bone disease.
Disorders of mineral metabolism
Includes disorders of calcium metabolism relevant to metabolic bone disease.
Disorders resulting from impaired renal tubular function
Includes renal osteodystrophy, a condition associated with metabolic bone disease.
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 osteoporosis is age-related and a fracture is present. |
|
| E83.5 | Disorders of calcium metabolism | Use when calcium metabolism disorders are present. |
|
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 metabolic bone disease
Essential facts and insights about Metabolic Bone Disease
Primary ICD-10-CM Codes for metabolic bone disease
Decision Criteria
clinical Criteria
- Presence of a pathological fracture in an elderly patient.
Applicable To
- Osteoporosis with fracture due to aging
Excludes
- Osteomalacia (M83)
Clinical Validation Requirements
- DEXA T-score ≤-2.5
- Fracture mechanism documentation
Code-Specific Risks
- Ensure fracture documentation is present.
Coding Notes
- Ensure to document the specific fracture site and mechanism.
E83.5 - Disorders of calcium metabolism
Use when calcium metabolism disorders are present.
Applicable To
- Hypercalcemia
- Hypocalcemia
Excludes
- Vitamin D deficiency (E55)
Clinical Validation Requirements
- Serum calcium levels outside 8.5-10.2 mg/dL
Coding Notes
Document specific calcium disorder and related lab findings.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Metabolic Bone Disease 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 clinical picture., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Use templates to ensure complete documentation.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure to use M80 when documenting a current fracture.
Impact
Lack of detailed fracture documentation.
Mitigation Strategy
Implement thorough documentation practices.
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 Metabolic Bone Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Metabolic Bone Disease
Use these documentation templates to ensure complete and accurate documentation for Metabolic Bone Disease. These templates include all required elements for proper coding and billing.
Osteoporosis with vertebral fracture
Specialty: OrthopedicsRequired Elements
- Fracture site
- DEXA score
- Calcium levels
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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