M80.8B2A: Other osteoporosis with current pathological fracture, left pelvis, initial encounter for fracture
M80.8B2A, other osteoporosis with current pathological fracture, left pelvis, initial encounter for fracture, is listed as a covered diagnosis in 9 Medicare billing and coding articles that apply to 19 HCPCS Level II codes, including G0130 (Single energy x-ray absorptiometry (sexa) bone density…), J3489 (Injection, zoledronic acid, 1 mg), J1740 (Injection, ibandronate sodium, 1 mg). The articles come from 4 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with M80.8B2A as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0130 | Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) | Special coverage instructions apply | — | 2 |
| J3489 | Injection, zoledronic acid, 1 mg | Carrier judgment | — | 1 |
| J1740 | Injection, ibandronate sodium, 1 mg | Carrier judgment | — | 1 |
| J2430 | Injection, pamidronate disodium, per 30 mg | Special coverage instructions apply | — | 1 |
| G0453 | Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure) | Carrier judgment | — | 1 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 3 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 2 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 2 |
| A9585 | Injection, gadobutrol, 0.1 ml | Carrier judgment | — | 1 |
| Q9953 | Injection, iron-based magnetic resonance contrast agent, per ml | Special coverage instructions apply | — | 1 |
| G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0158 | Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0160 | Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G2169 | Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G2010 | Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment | Carrier judgment | — | 1 |
| G2250 | Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment | Carrier judgment | — | 1 |
| G2251 | Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of clinical discussion | Carrier judgment | — | 1 |
| G0151 | Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| S2900 | Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) | Not payable by Medicare | Not covered | 1 |
Medicare policy articles listing M80.8B2A
- A56907: Billing and Coding: Bisphosphonate Drug Therapy (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L34648
- A59040: Billing and Coding: Bone Mass Measurement (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36460, L39268
- A57132: Billing and Coding: Bone Mass Measurement (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36460, L39268
- A57604: Billing and Coding: Intraoperative Neurophysiological Testing (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34623, L35003
- A60250: Billing and Coding: Total Joint Arthroplasty (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33456, L36039, L39911, L40232
- A57206: Billing and Coding: Lumbar MRI (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L34220
- A53057: Billing and Coding: Home Health Occupational Therapy (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34560
- A53064: Billing and Coding: Outpatient Occupational Therapy (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34427
- A57311: Billing and Coding: Physical Therapy - Home Health (CGS Administrators, LLC (HHH MAC); 7 Level II codes). LCD with the same title: L33942
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other M80 diagnoses (Osteoporosis with current pathological fracture)
- M80.8B1A — Other osteoporosis with current pathological fracture, right pelvis…
- M80.8B9A — Other osteoporosis with current pathological fracture, unspecified…
- M80.811A — Other osteoporosis with current pathological fracture, right…
- M80.812A — Other osteoporosis with current pathological fracture, left…
- M80.821A — Other osteoporosis with current pathological fracture, right…
- M80.822A — Other osteoporosis with current pathological fracture, left humerus…
- M80.831A — Other osteoporosis with current pathological fracture, right…
- M80.832A — Other osteoporosis with current pathological fracture, left forearm…
- M80.841A — Other osteoporosis with current pathological fracture, right hand…
- M80.842A — Other osteoporosis with current pathological fracture, left hand…
- M80.851A — Other osteoporosis with current pathological fracture, right femur…
- M80.852A — Other osteoporosis with current pathological fracture, left femur…
- M80.861A — Other osteoporosis with current pathological fracture, right lower…
- M80.862A — Other osteoporosis with current pathological fracture, left lower…
- M80.871A — Other osteoporosis with current pathological fracture, right ankle…
- M80.872A — Other osteoporosis with current pathological fracture, left ankle…
- M80.88XA — Other osteoporosis with current pathological fracture, vertebra(e)…
- M80.8AXA — Other osteoporosis with current pathological fracture, other site…
- M80.011A — Age-related osteoporosis with current pathological fracture, right…
- M80.012A — Age-related osteoporosis with current pathological fracture, left…
- M80.021A — Age-related osteoporosis with current pathological fracture, right…
- M80.022A — Age-related osteoporosis with current pathological fracture, left…
- M80.031A — Age-related osteoporosis with current pathological fracture, right…
- M80.032A — Age-related osteoporosis with current pathological fracture, left…
- M80.041A — Age-related osteoporosis with current pathological fracture, right…
- M80.042A — Age-related osteoporosis with current pathological fracture, left…
- M80.051A — Age-related osteoporosis with current pathological fracture, right…
- M80.052A — Age-related osteoporosis with current pathological fracture, left…
- M80.061A — Age-related osteoporosis with current pathological fracture, right…
- M80.062A — Age-related osteoporosis with current pathological fracture, left…
Frequently asked questions
Does Medicare cover M80.8B2A (Other osteoporosis with current pathological fracture…)?
Medicare covers items and services, not diagnoses. 9 Medicare billing and coding articles list M80.8B2A as a covered diagnosis for 19 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 M80.8B2A?
The Level II codes from the policies most specific to this diagnosis are G0130 (Single energy x-ray absorptiometry (sexa) bone density…, 2 articles); J3489 (Injection, zoledronic acid, 1 mg, 1 article); J1740 (Injection, ibandronate sodium, 1 mg, 1 article); J2430 (Injection, pamidronate disodium, per 30 mg, 1 article); G0453 (Continuous intraoperative neurophysiology monitoring, from…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list M80.8B2A?
A56907 (Billing and Coding: Bisphosphonate Drug Therapy); A59040 (Billing and Coding: Bone Mass Measurement); A57132 (Billing and Coding: Bone Mass Measurement), and 6 more articles.
What is ICD-10-CM code M80.8B2A?
M80.8B2A is the ICD-10-CM code for other osteoporosis with current pathological fracture, left pelvis, initial encounter for fracture, in category M80 (Osteoporosis with current pathological fracture), chapter 13: Diseases of the musculoskeletal system and connective tissue.
Next steps
- Run a reimbursement report for a device billed under G0130
- Watch G0130 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0130
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 13: Diseases of the musculoskeletal system and connective tissue · All diagnoses · HCPCS lookup