ICD-10 for Osteoporosis: M80/M81 with Fracture & Screening

In the United States, over 10 million people are living with osteoporosis, and nearly 44 million have low bone density, putting them at increased risk for fractures. Understanding the correct ICD-10 code for osteoporosis is essential for accurate diagnosis, billing, and treatment documentation. Whether you’re a clinician, coder, billing specialist or practice manager, understanding the correct code and when to use it.

In this guide, we’ll walk you through the codes for osteoporosis unspecified ICD-10, age-related osteoporosis ICD-10, postmenopausal osteoporosis ICD-10, and screening codes like ICD-10 screening for osteoporosis.

Hello MDs’ experts fill gaps that many competitors miss, integrate practical examples tied to real practice workflows, and ensure you leave with clear, actionable knowledge.

What Is the ICD-10 Code for Osteoporosis?

A common question among healthcare professionals is: what ICD-10 code should be used for osteoporosis? The answer depends on two key factors:

• Whether there is a current pathological fracture associated with the osteoporosis
• Whether there is a screening or diagnostic encounter

The main categories in the US version of the classification are:

• Category M80: Osteoporosis with current pathological fracture. There are several variations and subcategories based on the type of osteoporosis, fracture site, laterality and episode of care.
• Category M81: Osteoporosis without current pathological fracture. It is commonly used for diagnosis, screening, and management. Here are the most common codes used in this category, e.g M81.0, M81.6, M81.8, M81.4, M81.5, M81.9, M81.2 and M81.1
• Z-series codes such as Z13.820: Encounter for screening for osteoporosis. (See screening section below.)

Understanding ICD-10 coding for osteoporosis is just one part of effective chronic disease billing. Learn how similar coding applies to metabolic disorders in our post on Dyslipidemia ICD-10.

Types of Osteoporosis and Their ICD-10 Codes

Let’s break down three important subtypes of osteoporosis and how to code them correctly.

1. Age-Related Osteoporosis (ICD-10)

Often encountered in older adults, the term “age-related osteoporosis ICD-10” covers cases where bone density loss is largely due to aging/senescence, and there is no current pathological fracture.

• Use M81.0 for age-related osteoporosis without a current pathological fracture.
• If there is a fracture, you would use a relevant M80 code (e.g., M80.0X) that includes the fracture site.

Documentation Tip: Clearly mention “without current pathological fracture” and any past fractures as history (with Z87.310) when applicable.

2. Postmenopausal Osteoporosis (ICD-10)

Explicitly identifying postmenopausal osteoporosis can improve coding accuracy:

• M81.1: Postmenopausal osteoporosis without current pathological fracture.
• M80.1: Postmenopausal osteoporosis with current pathological fracture.

Because many practices just code “osteoporosis” generically, explicitly identifying “postmenopausal” etiology can support more accurate coding and billing.

3. Osteoporosis Unspecified (ICD-10).

When documentation lacks specific detail (etiology unclear, fracture status unknown), the term “osteoporosis unspecified ICD-10” or “unspecified osteoporosis ICD-10” becomes applicable.

• M81.9: Osteoporosis, unspecified, without current pathological fracture.
• M80.9: Osteoporosis, unspecified, with current pathological fracture.

But the use of these unspecified codes should be limited. they often trigger audits from payers or internal compliance teams. Good documentation through Hello MD’s medical coding services helps minimise the need for “unspecified” codes.

ICD-10 Code for Screening for Osteoporosis

Another area many miss: screening vs diagnosis. The term “ICD-10 code for osteoporosis screening” points to preventive care encounters (e.g., bone density scan/DXA) rather than a confirmed diagnosis.

• Z13.820: Encounter for screening for osteoporosis.

When a healthy (or asymptomatic) patient undergoes bone density screening, this Z-code is appropriate.

It’s essential to distinguish this from a diagnosis code: If osteoporosis is diagnosed during the visit, you transition to M80/M81 rather than a Z-code. Correct coding supports proper billing, avoids claim denials, and aligns with platforms like HelloMDs’ denial management and billing oversight services.

Workflow Example: How to Code Osteoporosis

Let’s walk through a workflow that links clinical documentation, coding, billing, and how Hello MDs integrates:
Scenario: A 72-year-old female patient presents for routine care. A DXA scan shows T-score -2.8 (osteoporosis). No current fracture.

1. Provider documents: “Postmenopausal osteoporosis, no current pathological fracture; DXA confirms T-score -2.8, patient will begin bisphosphonate.”
2. Coding uses M81.1 (postmenopausal osteoporosis without current pathological fracture).
3. Billing uses this code for the diagnosis; if screen only, use Z13.820.
4. Hello MDs reviewers ensure input is accurate, check for proper modifiers and diagnosis linkage, verify insurance eligibility, and monitor payment posting and denials.
5. After six months, the patient experiences a fragility fracture of the left femur; updated documentation:
   “Initial encounter for a left femur fracture in a patient with postmenopausal osteoporosis and a current pathological fracture”

Coders then move to M80.052A (left femur, initial encounter), and HelloMDs’ denial management team monitors for potential payor scrutiny.

This kind of integrated workflow, clinical, coding, billing, and revenue cycle, reflects how HelloMDs adds value. It also shows how catching the right code early (M81 vs M80) influences cost and reimbursement.

Common Mistakes and How to Avoid Them

• Using unspecified codes too often (e.g., M81.9) when more specific documentation exists.
• Failing to specify “with” vs “without” current fracture leading to incorrect use of M80 or M81.
• Neglecting screening codes using a diagnosis code when it’s only a screening visit (should be Z13.820).
• Not specifying the fracture site when using the M80 series is required per guidelines.
• Disconnect between coder and billing staff. HelloMDs helps link coding accuracy to billing and AR.
• Missing seventh-character modifiers for initial, subsequent, and sequela encounters in fracture codes (M80 series).

Why Accurate Osteoporosis ICD-10 Coding Matters

• Claim prevention: Incorrect coding (e.g., using a generic fracture code instead of M80) can lead to denial or underpayment.
• Documentation standards: Coders must see clear language: “pathological fracture due to osteoporosis,” “no current fracture,” “screening only,” etc.
• Revenue cycle alignment: Using the right code ties into billing, payment posting, denial management and AR, all core services provided by Hello MDs.
• Audit risk mitigation: Payers and CMS focus on high-cost diagnoses; osteoporosis with fracture can trigger reviews unless coded perfectly.
• Evolving guidelines: The 2026 edition of the ICD-10-CM and official guidelines emphasize the difference between M80 vs M81 and site specificity.

Conclusion:

Understanding osteoporosis ICD-10 codes isn’t just about choosing between M80 and M81. It’s about knowing when it’s for screening or diagnosis, whether there’s a fracture or not. How each detail ties back to smooth revenue management. If your office works with Hello MDS, accurate coding means cleaner claims, fewer denials, faster payments, and less stress. Keep this guide handy, fine-tune your process, and let your billing team stay compliant while you stay focused on patient care

Disclaimer:

This blog is intended for learning and reference, not as a substitute for professional medical or billing advice. Confirm all codes with official ICD-10 resources. Images are AI-generated to support understanding.