M83.1 ICD-10-CM Code: Senile osteomalacia
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Disorders of bone density and structure (M80-M85)
M83.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSenile osteomalacia
Softening of bones in elderly people due to vitamin D deficiency, causing bones to become weak and painful.
Buddy Insight
Senile osteomalacia represents bone softening in elderly patients due to vitamin D deficiency, indicating severe nutritional compromise with high fracture risk and functional impairment.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
MappedHCC 87
RAF 0.055
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for M83.1 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M83.1 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M83.1 in this effective period.
Excludes 1
Official- infantile and juvenile osteomalacia (E55.0)
- renal osteodystrophy (N25.0)
- rickets (active) (E55.0)
- rickets (active) sequelae (E64.3)
- vitamin D-resistant osteomalacia (E83.31)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M83.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M83.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M83.1 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is M83.1 an HCC code?
M83.1 is not in the CMS-HCC V28 or V24 community payment model, but it does map to Osteoporosis, Vertebral and Pathological Fractures under the Part D RxHCC model.
HCC Category Mapping
Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
Work M83.1 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for M83.1
For M83.1to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed M83.1 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
M83.1 is the ICD-10-CM diagnosis code for senile osteomalacia. Softening of bones in elderly people due to vitamin D deficiency, causing bones to become weak and painful. M83.1 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).
M83.1 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
This code does not map to a CMS-HCC V28 payment category. Capture depends on documentation that supports the diagnosis; verify the HCC assignment against the current CMS mapping for the applicable payment year. Coders reviewing M83.1 should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M83.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is distinct from age-related osteoporosis (M81.0) as it involves bone softening rather than density loss
- •Often associated with limited sun exposure and poor dietary vitamin D intake in elderly patients
Clinical Significance
Senile osteomalacia represents bone softening in elderly patients due to vitamin D deficiency, indicating severe nutritional compromise with high fracture risk and functional impairment. This diagnosis requires comprehensive geriatric assessment, nutritional intervention, and fall prevention strategies.
Documentation Requirements
- ✓Documentation of osteomalacia in elderly patient population
- ✓Clinical or radiographic evidence of bone softening
- ✓Laboratory evidence of vitamin D deficiency when available
- ✓Age-appropriate documentation (typically >65 years)
- ✓Assessment of dietary intake and sun exposure
- ✓Treatment with vitamin D and calcium supplementation
- ✓Evaluation for malabsorption or other contributing factors