M81.0 ICD-10-CM Code: Age-related osteoporosis without current pathological fracture
M81.0 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Disorders of bone density and structure (M80-M85)
M81.0
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAge-related osteoporosis without current pathological fracture
Weakening of bones due to aging, where bones become more fragile and prone to breaking, but no fracture has currently occurred.
Buddy Insight
Age-related osteoporosis without fracture represents significant bone density loss that increases fracture risk and functional limitations, requiring ongoing monitoring and preventive interventions.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
Context neededHCC 87
Coefficient needs member context
Code Book Path
Inclusion Terms
Official- Involutional osteoporosis without current pathological fracture
- Osteoporosis NOS
- Postmenopausal osteoporosis without current pathological fracture
- Senile osteoporosis without current pathological fracture
Excludes 2
Official- arthropathic psoriasis (L40.5-)Inherited from M00-M99
- certain conditions originating in the perinatal period (P04-P96)Inherited from M00-M99
- certain infectious and parasitic diseases (A00-B99)Inherited from M00-M99
- compartment syndrome (traumatic) (T79.A-)Inherited from M00-M99
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from M00-M99
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from M00-M99
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from M00-M99
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from M00-M99
- neoplasms (C00-D49)Inherited from M00-M99
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from M00-M99
Related Codes
Includes
OfficialNo Includes notes are included in this display for M81.0. Check the code and parent instructions in the Code Book.
Excludes 1
Official- osteoporosis with current pathological fracture (M80.-)Inherited from M81
- Sudeck's atrophy (M89.0)Inherited from M81
Code First
OfficialNo Code First sequencing instructions are included in this display for M81.0. Check the code and parent instructions in the Code Book.
Use Additional
Official- code to identify:Inherited from M81
- major osseous defect, if applicable (M89.7-)Inherited from M81
- personal history of (healed) osteoporosis fracture, if applicable (Z87.310)Inherited from M81
Code Also
OfficialNo Code Also instructions are included in this display for M81.0. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is M81.0 an HCC code?
M81.0 has no mapping under the current CMS-HCC V28 community payment model. M81.0 has a separate mapping under the Part D RxHCC model (HCC 87 (Osteoporosis, Vertebral and Pathological Fractures)); the applicable result needs member context.
- Code
- M81.0
- Description
- Age-related osteoporosis without current pathological fracture
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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What This Code Means
M81.0 is the ICD-10-CM diagnosis code for age-related osteoporosis without current pathological fracture. Weakening of bones due to aging, where bones become more fragile and prone to breaking, but no fracture has currently occurred. M81.0 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering disorders of bone density and structure (m80-m85).
M81.0 has no mapping under the current CMS-HCC V28 community payment model. M81.0 has a separate mapping under the Part D RxHCC model (HCC 87 (Osteoporosis, Vertebral and Pathological Fractures)); the applicable result needs member context. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
Do not use this code if a pathological fracture is present; use M80 codes instead.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for M81.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Do not use this code if a pathological fracture is present; use M80 codes instead
- •This is commonly seen in postmenopausal women and elderly patients; document risk factors when present
Clinical Significance
Age-related osteoporosis without fracture represents significant bone density loss that increases fracture risk and functional limitations, requiring ongoing monitoring and preventive interventions. This diagnosis indicates need for bone health management, fall prevention strategies, and regular surveillance for complications.
Documentation Requirements
- ✓Documentation of osteoporosis diagnosis through DEXA scan or clinical criteria
- ✓Confirmation that osteoporosis is age-related (postmenopausal or senile)
- ✓Absence of current pathological fracture
- ✓Bone density measurements (T-scores) when available
- ✓Assessment of fracture risk factors
- ✓Treatment and prevention strategies documented
- ✓Exclusion of secondary causes of osteoporosis