Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesDisorders of bone density and structureICD-10-CM m85-other-bone-density-disorders
    Ask Trek AI about this page

    ICD-10-CM Code For Other Disorders Of Bone Density And Structure: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group M85 includes diagnoses for other disorders of bone density and structure such as acquired deformities, localized osteopenia, and disorders of bone growth and remodeling that are not classified elsewhere. These ICD-10-CM diagnosis codes are used to document clinical presentations involving altered bone density, structural deformities, or abnormal bone development, capturing severity and anatomic involvement relevant to this group. Accurate coding within the ICD-10-CM M85 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

    Customize your policy alerts

    Sign up for ICD-10-CM Code For Other Disorders Of Bone Density And Structure: Group Overview policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    ICD-10-CM M85: Other Disorders Of Bone Density And Structure Overview

    The ICD-10-CM M85 group covers disorders affecting bone density and the structural integrity of the skeleton outside of primary osteoporosis and osteomalacia. These conditions target the musculoskeletal system, including localized and generalized changes in bone density, defects of bone growth, and disturbances in bone architecture. Accurate coding matters for appropriate claim adjudication and to reflect clinical complexity for reimbursement.

    Table of contents

    Progress1 / 6

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    When to Use

    Use a code from this group when clinical evaluation identifies altered bone density, localized bone loss, bone deformity, or structural abnormalities that are specified as other disorders of bone density and structure. Select the most specific code reflecting anatomic site, laterality, and documented etiology when available.

    ICD-10-CM Codes

    169 rows

    ICD-10-CM CodeDescription
    M85.00Fibrous dysplasia (monostotic), unspecified site
    M85.011Fibrous dysplasia (monostotic), right shoulder
    M85.012Fibrous dysplasia (monostotic), left shoulder
    M85.019Fibrous dysplasia (monostotic), unspecified shoulder
    M85.021Fibrous dysplasia (monostotic), right upper arm
    M85.022Fibrous dysplasia (monostotic), left upper arm
    M85.029Fibrous dysplasia (monostotic), unspecified upper arm
    M85.031Fibrous dysplasia (monostotic), right forearm
    M85.032Fibrous dysplasia (monostotic), left forearm
    M85.039Fibrous dysplasia (monostotic), unspecified forearm
    M85.041Fibrous dysplasia (monostotic), right hand
    M85.042Fibrous dysplasia (monostotic), left hand
    M85.049Fibrous dysplasia (monostotic), unspecified hand
    M85.051Fibrous dysplasia (monostotic), right thigh
    M85.052Fibrous dysplasia (monostotic), left thigh
    M85.059Fibrous dysplasia (monostotic), unspecified thigh
    M85.061Fibrous dysplasia (monostotic), right lower leg
    M85.062Fibrous dysplasia (monostotic), left lower leg
    M85.069Fibrous dysplasia (monostotic), unspecified lower leg
    M85.071Fibrous dysplasia (monostotic), right ankle and foot

    Showing 1–20 of 169

    • More pages

    DRG Codes

    5 rows

    DRG CodeDescription
    553Bone Diseases and Arthropathies with MCC
    554Bone Diseases and Arthropathies without MCC
    564Other Musculoskeletal System and Connective Tissue Diagnoses with MCC
    565Other Musculoskeletal System and Connective Tissue Diagnoses with CC
    566Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCC

    Typical Clinical Scenarios

    • A 72-year-old woman with progressive back pain, height loss over several years, and recent thoracic compression fracture after a low-energy fall presents to the outpatient bone clinic for evaluation of bone quality. Imaging shows generalized decreased cortical thickness and multiple vertebral deformities without biochemical evidence of metabolic bone disease; the clinician assigns a code from this group to document an unspecified osteopenic/structural bone disorder contributing to fragility fractures. Typical codes: M85.80, M85.89.
    • A 35-year-old man with a history of long-term corticosteroid therapy for inflammatory bowel disease is referred for persistent diffuse bone pain and imaging demonstrating focal osteopenia and altered bone architecture in multiple long bones; this is managed as a chronic disorder of bone density and structure related to medication effects and secondary bone weakening, warranting a specific code from this group to capture the underlying bone structural abnormality. Typical codes: M85.30, M85.31.
    • An adolescent with a congenital connective tissue disorder is seen for evaluation of abnormal bone modeling and recurrent nonunion fractures; orthopedic surgeons document localized disturbances of bone density and structure at the fracture sites complicating healing, so a code from this group is used as a comorbid diagnosis to explain poor bone quality and guide care. Typical codes: M85.20, M85.29.

    Related Codes

    M80-OSTEOPOROSIS-WITH-PATHOLOGICAL-FRACTURE

    ICD-10-CM Code For Osteoporosis With Current Pathological Fracture: Group Overview

    M81-OSTEOPOROSIS-WITHOUT-FRACTURE

    ICD-10-CM Code For Osteoporosis Without Current Pathological Fracture: Group Overview

    M83-ADULT-OSTEOMALACIA

    ICD-10-CM Code For Adult Osteomalacia: Group Overview

    M84-DISORDER-OF-CONTINUITY-OF-BONE

    ICD-10-CM Code For Disorder Of Continuity Of Bone: Group Overview

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.