M81.8

Billable

Other osteoporosis without current pathological fracture

HCC Category Mapping

RxHCCHCC 87 — Osteoporosis, Vertebral and Pathological Fractures

0.000

What This Code Means

Weakening of bones from causes other than age-related changes, where bones become more fragile and prone to breaking, but no fracture has currently occurred.

Coding Tips

•Use this code for osteoporosis due to endocrine disorders, medications, or other non-age-related causes
•Document the underlying cause when known to support medical necessity

Clinical Significance

Other osteoporosis represents bone density loss due to secondary causes such as medications, endocrine disorders, or systemic diseases, indicating more complex pathophysiology requiring treatment of underlying conditions. This diagnosis suggests need for comprehensive evaluation and management of both bone health and causative factors.

Documentation Requirements

✓Documentation of osteoporosis from secondary causes
✓Identification of underlying condition causing osteoporosis
✓Bone density measurements confirming osteoporosis
✓Absence of current pathological fracture
✓Documentation that cause is not age-related
✓Evidence of treatment addressing underlying cause
✓Assessment of additional fracture risk factors

Use Additional Code

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)