Medicare Informatics - Medicare Informatics & Data Analysis in Cloud

Diseases of the musculoskeletal system and connective tissue (M00-M99)

Note:: Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition

Excludes 2:: arthropathic psoriasis (L40.5-)
certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
compartment syndrome (traumatic) (T79.A-)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Disorders of bone density and structure (M80-M85)

M80

Osteoporosis with current pathological fracture [+]

Includes:	osteoporosis with current fragility fracture
Use additional	code to identify major osseous defect, if applicable (M89.7-)
Excludes 1:	collapsed vertebra NOS (M48.5) pathological fracture NOS (M84.4) wedging of vertebra NOS (M48.5)
Excludes 2:	personal history of (healed) osteoporosis fracture (Z87.310)
The appropriate 7th character is to be added to each code from category M80: A - initial encounter for fracture D - subsequent encounter for fracture with routine healing G - subsequent encounter for fracture with delayed healing K - subsequent encounter for fracture with nonunion P - subsequent encounter for fracture with malunion S - sequela

M80.0

Age-related osteoporosis with current pathological fracture [+]
Involutional osteoporosis with current pathological fracture
Osteoporosis NOS with current pathological fracture
Postmenopausal osteoporosis with current pathological fracture
Senile osteoporosis with current pathological fracture

M80.00

Age-related osteoporosis with current pathological fracture, unspecified site

M80.01

Age-related osteoporosis with current pathological fracture, shoulder [+]

M80.02

Age-related osteoporosis with current pathological fracture, humerus [+]

M80.03

Age-related osteoporosis with current pathological fracture, forearm [+]
Age-related osteoporosis with current pathological fracture of wrist

M80.04

Age-related osteoporosis with current pathological fracture, hand [+]

M80.05

Age-related osteoporosis with current pathological fracture, femur [+]
Age-related osteoporosis with current pathological fracture of hip

M80.06

Age-related osteoporosis with current pathological fracture, lower leg [+]

M80.07

Age-related osteoporosis with current pathological fracture, ankle and foot [+]

M80.08

Age-related osteoporosis with current pathological fracture, vertebra(e)

M80.0A

Age-related osteoporosis with current pathological fracture, other site

M80.0B

Age-related osteoporosis with current pathological fracture, pelvis [+]

M80.8

Other osteoporosis with current pathological fracture [+]
Drug-induced osteoporosis with current pathological fracture
Idiopathic osteoporosis with current pathological fracture
Osteoporosis of disuse with current pathological fracture
Postoophorectomy osteoporosis with current pathological fracture
Postsurgical malabsorption osteoporosis with current pathological fracture
Post-traumatic osteoporosis with current pathological fracture

Use additional

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

M80.80

Other osteoporosis with current pathological fracture, unspecified site

M80.81

Other osteoporosis with pathological fracture, shoulder [+]

M80.82

Other osteoporosis with current pathological fracture, humerus [+]

M80.83

Other osteoporosis with current pathological fracture, forearm [+]
Other osteoporosis with current pathological fracture of wrist

M80.84

Other osteoporosis with current pathological fracture, hand [+]

M80.85

Other osteoporosis with current pathological fracture, femur [+]
Other osteoporosis with current pathological fracture of hip

M80.86

Other osteoporosis with current pathological fracture, lower leg [+]

M80.87

Other osteoporosis with current pathological fracture, ankle and foot [+]

M80.88

Other osteoporosis with current pathological fracture, vertebra(e)

M80.8A

Other osteoporosis with current pathological fracture, other site

M80.8B

Other osteoporosis with current pathological fracture, pelvis [+]

M81

Osteoporosis without current pathological fracture [+]

Use additional	code to identify:
Use additional	major osseous defect, if applicable (M89.7-)
Use additional	personal history of (healed) osteoporosis fracture, if applicable (Z87.310)
Excludes 1:	osteoporosis with current pathological fracture (M80.-) Sudeck's atrophy (M89.0)

M83

Adult osteomalacia [+]

Excludes 1:

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)
vitamin D-resistant rickets (active) (E83.31)

M84

Disorder of continuity of bone [+]

Excludes 2:

traumatic fracture of bone-see fracture, by site

M84.3

Stress fracture [+]
Fatigue fracture
March fracture
Stress fracture NOS
Stress reaction

Use additional	external cause code(s) to identify the cause of the stress fracture
Excludes 1:	pathological fracture NOS (M84.4.-) pathological fracture due to osteoporosis (M80.-) traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)
Excludes 2:	personal history of (healed) stress (fatigue) fracture (Z87.312) stress fracture of vertebra (M48.4-)
The appropriate 7th character is to be added to each code from subcategory M84.3: A - initial encounter for fracture D - subsequent encounter for fracture with routine healing G - subsequent encounter for fracture with delayed healing K - subsequent encounter for fracture with nonunion P - subsequent encounter for fracture with malunion S - sequela

M84.30

Stress fracture, unspecified site

M84.31

Stress fracture, shoulder [+]

M84.32

Stress fracture, humerus [+]

M84.33

Stress fracture, ulna and radius [+]

M84.34

Stress fracture, hand and fingers [+]

M84.35

Stress fracture, pelvis and femur [+]
Stress fracture, hip

M84.36

Stress fracture, tibia and fibula [+]

M84.37

Stress fracture, ankle, foot and toes [+]

M84.38

Stress fracture, other site

Excludes 2:

stress fracture of vertebra (M48.4-)

M84.4

Pathological fracture, not elsewhere classified [+]
Chronic fracture
Pathological fracture NOS

Excludes 1:	collapsed vertebra NEC (M48.5) pathological fracture in neoplastic disease (M84.5-) pathological fracture in osteoporosis (M80.-) pathological fracture in other disease (M84.6-) stress fracture (M84.3-) traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)
Excludes 2:	personal history of (healed) pathological fracture (Z87.311)
The appropriate 7th character is to be added to each code from subcategory M84.4: A - initial encounter for fracture D - subsequent encounter for fracture with routine healing G - subsequent encounter for fracture with delayed healing K - subsequent encounter for fracture with nonunion P - subsequent encounter for fracture with malunion S - sequela

M84.40

Pathological fracture, unspecified site

M84.41

Pathological fracture, shoulder [+]

M84.42

Pathological fracture, humerus [+]

M84.43

Pathological fracture, ulna and radius [+]

M84.44

Pathological fracture, hand and fingers [+]

M84.45

Pathological fracture, femur and pelvis [+]

M84.46

Pathological fracture, tibia and fibula [+]

M84.47

Pathological fracture, ankle, foot and toes [+]

M84.48

Pathological fracture, other site

M84.5

Pathological fracture in neoplastic disease [+]

Code also	underlying neoplasm
The appropriate 7th character is to be added to each code from subcategory M84.5: A - initial encounter for fracture D - subsequent encounter for fracture with routine healing G - subsequent encounter for fracture with delayed healing K - subsequent encounter for fracture with nonunion P - subsequent encounter for fracture with malunion S - sequela

M84.50

Pathological fracture in neoplastic disease, unspecified site

M84.51

Pathological fracture in neoplastic disease, shoulder [+]

M84.52

Pathological fracture in neoplastic disease, humerus [+]

M84.53

Pathological fracture in neoplastic disease, ulna and radius [+]

M84.54

Pathological fracture in neoplastic disease, hand [+]

M84.55

Pathological fracture in neoplastic disease, pelvis and femur [+]

M84.56

Pathological fracture in neoplastic disease, tibia and fibula [+]

M84.57

Pathological fracture in neoplastic disease, ankle and foot [+]

M84.58

Pathological fracture in neoplastic disease, other specified site
Pathological fracture in neoplastic disease, vertebrae

M84.6

Pathological fracture in other disease [+]

Code also	underlying condition
Excludes 1:	pathological fracture in osteoporosis (M80.-)
The appropriate 7th character is to be added to each code from subcategory M84.6: A - initial encounter for fracture D - subsequent encounter for fracture with routine healing G - subsequent encounter for fracture with delayed healing K - subsequent encounter for fracture with nonunion P - subsequent encounter for fracture with malunion S - sequela

M84.60

Pathological fracture in other disease, unspecified site

M84.61

Pathological fracture in other disease, shoulder [+]

M84.62

Pathological fracture in other disease, humerus [+]

M84.63

Pathological fracture in other disease, ulna and radius [+]

M84.64

Pathological fracture in other disease, hand [+]

M84.65

Pathological fracture in other disease, pelvis and femur [+]

M84.66

Pathological fracture in other disease, tibia and fibula [+]

M84.67

Pathological fracture in other disease, ankle and foot [+]

M84.68

Pathological fracture in other disease, other site

M84.7

Nontraumatic fracture, not elsewhere classified [+]

M84.75

Atypical femoral fracture [+]

The appropriate 7th character is to be added to each code from M84.75:
A - initial encounter for fracture
D - subsequent encounter for fracture with routine healing
G - subsequent encounter for fracture with delayed healing
K - subsequent encounter for fracture with nonunion
P - subsequent encounter for fracture with malunion
S - sequela

M84.8

Other disorders of continuity of bone [+]

M84.80

Other disorders of continuity of bone, unspecified site

M84.81

Other disorders of continuity of bone, shoulder [+]

M84.82

Other disorders of continuity of bone, humerus [+]

M84.83

Other disorders of continuity of bone, ulna and radius [+]

M84.84

Other disorders of continuity of bone, hand [+]

M84.85

Other disorders of continuity of bone, pelvic region and thigh [+]

M84.86

Other disorders of continuity of bone, tibia and fibula [+]

M84.87

Other disorders of continuity of bone, ankle and foot [+]

M84.88

Other disorders of continuity of bone, other site

M84.9

Disorder of continuity of bone, unspecified

M85

Other disorders of bone density and structure [+]

Excludes 1:

osteogenesis imperfecta (Q78.0)
osteopetrosis (Q78.2)
osteopoikilosis (Q78.8)
polyostotic fibrous dysplasia (Q78.1)

M85.0

Fibrous dysplasia (monostotic) [+]

Excludes 2:

fibrous dysplasia of jaw (M27.8)

M85.00

Fibrous dysplasia (monostotic), unspecified site

M85.01

Fibrous dysplasia (monostotic), shoulder [+]

M85.02

Fibrous dysplasia (monostotic), upper arm [+]

M85.03

Fibrous dysplasia (monostotic), forearm [+]

M85.04

Fibrous dysplasia (monostotic), hand [+]

M85.05

Fibrous dysplasia (monostotic), thigh [+]

M85.06

Fibrous dysplasia (monostotic), lower leg [+]

M85.07

Fibrous dysplasia (monostotic), ankle and foot [+]

M85.08

Fibrous dysplasia (monostotic), other site

M85.09

Fibrous dysplasia (monostotic), multiple sites

M85.1

Skeletal fluorosis [+]

M85.10

Skeletal fluorosis, unspecified site

M85.11

Skeletal fluorosis, shoulder [+]

M85.12

Skeletal fluorosis, upper arm [+]

M85.13

Skeletal fluorosis, forearm [+]

M85.14

Skeletal fluorosis, hand [+]

M85.15

Skeletal fluorosis, thigh [+]

M85.16

Skeletal fluorosis, lower leg [+]

M85.17

Skeletal fluorosis, ankle and foot [+]

M85.18

Skeletal fluorosis, other site

M85.19

Skeletal fluorosis, multiple sites

M85.2

Hyperostosis of skull

M85.3

Osteitis condensans [+]

M85.30

Osteitis condensans, unspecified site

M85.31

Osteitis condensans, shoulder [+]

M85.32

Osteitis condensans, upper arm [+]

M85.33

Osteitis condensans, forearm [+]

M85.34

Osteitis condensans, hand [+]

M85.35

Osteitis condensans, thigh [+]

M85.36

Osteitis condensans, lower leg [+]

M85.37

Osteitis condensans, ankle and foot [+]

M85.38

Osteitis condensans, other site

M85.39

Osteitis condensans, multiple sites

M85.4

Solitary bone cyst [+]

Excludes 2:

solitary cyst of jaw (M27.4)

M85.40

Solitary bone cyst, unspecified site

M85.41

Solitary bone cyst, shoulder [+]

M85.42

Solitary bone cyst, humerus [+]

M85.43

Solitary bone cyst, ulna and radius [+]

M85.44

Solitary bone cyst, hand [+]

M85.45

Solitary bone cyst, pelvis [+]

M85.46

Solitary bone cyst, tibia and fibula [+]

M85.47

Solitary bone cyst, ankle and foot [+]

M85.48

Solitary bone cyst, other site

M85.5

Aneurysmal bone cyst [+]

Excludes 2:

aneurysmal cyst of jaw (M27.4)

M85.50

Aneurysmal bone cyst, unspecified site

M85.51

Aneurysmal bone cyst, shoulder [+]

M85.52

Aneurysmal bone cyst, upper arm [+]

M85.53

Aneurysmal bone cyst, forearm [+]

M85.54

Aneurysmal bone cyst, hand [+]

M85.55

Aneurysmal bone cyst, thigh [+]

M85.56

Aneurysmal bone cyst, lower leg [+]

M85.57

Aneurysmal bone cyst, ankle and foot [+]

M85.58

Aneurysmal bone cyst, other site

M85.59

Aneurysmal bone cyst, multiple sites

M85.6

Other cyst of bone [+]

Excludes 1:

cyst of jaw NEC (M27.4)
osteitis fibrosa cystica generalisata [von Recklinghausen's disease of bone] (E21.0)

M85.60

Other cyst of bone, unspecified site

M85.61

Other cyst of bone, shoulder [+]

M85.62

Other cyst of bone, upper arm [+]

M85.63

Other cyst of bone, forearm [+]

M85.64

Other cyst of bone, hand [+]

M85.65

Other cyst of bone, thigh [+]

M85.66

Other cyst of bone, lower leg [+]

M85.67

Other cyst of bone, ankle and foot [+]

M85.68

Other cyst of bone, other site

M85.69

Other cyst of bone, multiple sites

M85.8

Other specified disorders of bone density and structure [+]
Hyperostosis of bones, except skull
Osteosclerosis, acquired

Excludes 1:

diffuse idiopathic skeletal hyperostosis [DISH] (M48.1)
osteosclerosis congenita (Q77.4)
osteosclerosis fragilitas (generalista) (Q78.2)
osteosclerosis myelofibrosis (D75.81)

M85.80

Other specified disorders of bone density and structure, unspecified site

M85.81

Other specified disorders of bone density and structure, shoulder [+]