Notification



Notification Issue Date:



Policy Attachment



Attachment to Policy # 08.00.94m


Attachment:A

Policy #:08.00.94m

Description:ICD-10-CM Codes

Title:Denosumab (Proliaź, Xgevaź), Romosozumab-aqqg (Evenity™)


Inclusion of a code in this table does not imply reimbursement. Eligibility, benefits, limitations, exclusions, precertification/referral requirements, provider contracts, and Company policies apply.

The codes listed below are updated on a regular basis, in accordance with nationally accepted coding guidelines. Therefore, this policy applies to any and all future applicable coding changes, revisions, or updates.

In order to ensure optimal reimbursement, all health care services, devices, and pharmaceuticals should be reported using the billing codes and modifiers that most accurately represent the services rendered, unless otherwise directed by the Company.



ROMOSOZUMAB-AQQG (EVENITY™) IS MEDICALLY NECESSARY WHEN REPORTED WITH THE FOLLOWING DIAGNOSIS CODE:

M80.00XA Age-related osteoporosis with current pathological fracture, unspecified site, initial encounter for fracture

M80.00XD Age-related osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with routine healing

M80.00XG Age-related osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with delayed healing

M80.00XK Age-related osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with nonunion

M80.00XP Age-related osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with malunion

M80.00XS Age-related osteoporosis with current pathological fracture, unspecified site, sequela

M80.011A Age-related osteoporosis with current pathological fracture, right shoulder, initial encounter for fracture

M80.011D Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with routine healing

M80.011G Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with delayed healing

M80.011K Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with nonunion

M80.011P Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with malunion

M80.011S Age-related osteoporosis with current pathological fracture, right shoulder, sequela

M80.012A Age-related osteoporosis with current pathological fracture, left shoulder, initial encounter for fracture

M80.012D Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with routine healing

M80.012G Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with delayed healing

M80.012K Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with nonunion

M80.012P Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with malunion

M80.012S Age-related osteoporosis with current pathological fracture, left shoulder, sequela

M80.019A Age-related osteoporosis with current pathological fracture, unspecified shoulder, initial encounter for fracture

M80.019D Age-related osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with routine healing

M80.019G Age-related osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with delayed healing

M80.019K Age-related osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with nonunion

M80.019P Age-related osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with malunion

M80.019S Age-related osteoporosis with current pathological fracture, unspecified shoulder, sequela

M80.021A Age-related osteoporosis with current pathological fracture, right humerus, initial encounter for fracture

M80.021D Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with routine healing

M80.021G Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with delayed healing

M80.021K Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with nonunion

M80.021P Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with malunion

M80.021S Age-related osteoporosis with current pathological fracture, right humerus, sequela

M80.022A Age-related osteoporosis with current pathological fracture, left humerus, initial encounter for fracture

M80.022D Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with routine healing

M80.022G Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with delayed healing

M80.022K Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with nonunion

M80.022P Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with malunion

M80.022S Age-related osteoporosis with current pathological fracture, left humerus, sequela

M80.029A Age-related osteoporosis with current pathological fracture, unspecified humerus, initial encounter for fracture

M80.029D Age-related osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with routine healing

M80.029G Age-related osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with delayed healing

M80.029K Age-related osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with nonunion

M80.029P Age-related osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with malunion

M80.029S Age-related osteoporosis with current pathological fracture, unspecified humerus, sequela

M80.031A Age-related osteoporosis with current pathological fracture, right forearm, initial encounter for fracture

M80.031D Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with routine healing

M80.031G Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with delayed healing

M80.031K Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with nonunion

M80.031P Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with malunion

M80.031S Age-related osteoporosis with current pathological fracture, right forearm, sequela

M80.032A Age-related osteoporosis with current pathological fracture, left forearm, initial encounter for fracture

M80.032D Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with routine healing

M80.032G Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with delayed healing

M80.032K Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with nonunion

M80.032P Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with malunion

M80.032S Age-related osteoporosis with current pathological fracture, left forearm, sequela

M80.039A Age-related osteoporosis with current pathological fracture, unspecified forearm, initial encounter for fracture

M80.039D Age-related osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with routine healing

M80.039G Age-related osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with delayed healing

M80.039K Age-related osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with nonunion

M80.039P Age-related osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with malunion

M80.039S Age-related osteoporosis with current pathological fracture, unspecified forearm, sequela

M80.041A Age-related osteoporosis with current pathological fracture, right hand, initial encounter for fracture

M80.041D Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with routine healing

M80.041G Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with delayed healing

M80.041K Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with nonunion

M80.041P Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with malunion

M80.041S Age-related osteoporosis with current pathological fracture, right hand, sequela

M80.042A Age-related osteoporosis with current pathological fracture, left hand, initial encounter for fracture

M80.042D Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with routine healing

M80.042G Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with delayed healing

M80.042K Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with nonunion

M80.042P Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with malunion

M80.042S Age-related osteoporosis with current pathological fracture, left hand, sequela

M80.049A Age-related osteoporosis with current pathological fracture, unspecified hand, initial encounter for fracture

M80.049D Age-related osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with routine healing

M80.049G Age-related osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with delayed healing

M80.049K Age-related osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with nonunion

M80.049P Age-related osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with malunion

M80.049S Age-related osteoporosis with current pathological fracture, unspecified hand, sequela

M80.051A Age-related osteoporosis with current pathological fracture, right femur, initial encounter for fracture

M80.051D Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with routine healing

M80.051G Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with delayed healing

M80.051K Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with nonunion

M80.051P Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with malunion

M80.051S Age-related osteoporosis with current pathological fracture, right femur, sequela

M80.052A Age-related osteoporosis with current pathological fracture, left femur, initial encounter for fracture

M80.052D Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with routine healing

M80.052G Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with delayed healing

M80.052K Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with nonunion

M80.052P Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with malunion

M80.052S Age-related osteoporosis with current pathological fracture, left femur, sequela

M80.059A Age-related osteoporosis with current pathological fracture, unspecified femur, initial encounter for fracture

M80.059D Age-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with routine healing

M80.059G Age-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with delayed healing

M80.059K Age-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with nonunion

M80.059P Age-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with malunion

M80.059S Age-related osteoporosis with current pathological fracture, unspecified femur, sequela

M80.061A Age-related osteoporosis with current pathological fracture, right lower leg, initial encounter for fracture

M80.061D Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with routine healing

M80.061G Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with delayed healing

M80.061K Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with nonunion

M80.061P Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with malunion

M80.061S Age-related osteoporosis with current pathological fracture, right lower leg, sequela

M80.062A Age-related osteoporosis with current pathological fracture, left lower leg, initial encounter for fracture

M80.062D Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with routine healing

M80.062G Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with delayed healing

M80.062K Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with nonunion

M80.062P Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with malunion

M80.062S Age-related osteoporosis with current pathological fracture, left lower leg, sequela

M80.069A Age-related osteoporosis with current pathological fracture, unspecified lower leg, initial encounter for fracture

M80.069D Age-related osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with routine healing

M80.069G Age-related osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with delayed healing

M80.069K Age-related osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with nonunion

M80.069P Age-related osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with malunion

M80.069S Age-related osteoporosis with current pathological fracture, unspecified lower leg, sequela

M80.071A Age-related osteoporosis with current pathological fracture, right ankle and foot, initial encounter for fracture

M80.071D Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with routine healing

M80.071G Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with delayed healing

M80.071K Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with nonunion

M80.071P Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with malunion

M80.071S Age-related osteoporosis with current pathological fracture, right ankle and foot, sequela

M80.072A Age-related osteoporosis with current pathological fracture, left ankle and foot, initial encounter for fracture

M80.072D Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with routine healing

M80.072G Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with delayed healing

M80.072K Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with nonunion

M80.072P Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with malunion

M80.072S Age-related osteoporosis with current pathological fracture, left ankle and foot, sequela

M80.079A Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, initial encounter for fracture

M80.079D Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with routine healing

M80.079G Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with delayed healing

M80.079K Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with nonunion

M80.079P Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with malunion

M80.079S Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, sequela

M80.08XA Age-related osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture

M80.08XD Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with routine healing

M80.08XG Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with delayed healing

M80.08XK Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with nonunion

M80.08XP Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with malunion

M80.08XS Age-related osteoporosis with current pathological fracture, vertebra(e), sequela

M81.0 Age-related osteoporosis without current pathological fracture


DENOSUMAB (PROLIAź) IS MEDICALLY NECESSARY WHEN REPORTED WITH THE FOLLOWING DIAGNOSIS CODES:

M80.00XA Age-related osteoporosis with current pathological fracture, unspecified site, initial encounter for fracture

M80.00XD Age-related osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with routine healing

M80.00XG Age-related osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with delayed healing

M80.00XK Age-related osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with nonunion

M80.00XP Age-related osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with malunion

M80.00XS Age-related osteoporosis with current pathological fracture, unspecified site, sequela

M80.011A Age-related osteoporosis with current pathological fracture, right shoulder, initial encounter for fracture

M80.011D Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with routine healing

M80.011G Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with delayed healing

M80.011K Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with nonunion

M80.011P Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with malunion

M80.011S Age-related osteoporosis with current pathological fracture, right shoulder, sequela

M80.012A Age-related osteoporosis with current pathological fracture, left shoulder, initial encounter for fracture

M80.012D Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with routine healing

M80.012G Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with delayed healing

M80.012K Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with nonunion

M80.012P Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with malunion

M80.012S Age-related osteoporosis with current pathological fracture, left shoulder, sequela

M80.019A Age-related osteoporosis with current pathological fracture, unspecified shoulder, initial encounter for fracture

M80.019D Age-related osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with routine healing

M80.019G Age-related osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with delayed healing

M80.019K Age-related osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with nonunion

M80.019P Age-related osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with malunion

M80.019S Age-related osteoporosis with current pathological fracture, unspecified shoulder, sequela

M80.021A Age-related osteoporosis with current pathological fracture, right humerus, initial encounter for fracture

M80.021D Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with routine healing

M80.021G Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with delayed healing

M80.021K Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with nonunion

M80.021P Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with malunion

M80.021S Age-related osteoporosis with current pathological fracture, right humerus, sequela

M80.022A Age-related osteoporosis with current pathological fracture, left humerus, initial encounter for fracture

M80.022D Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with routine healing

M80.022G Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with delayed healing

M80.022K Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with nonunion

M80.022P Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with malunion

M80.022S Age-related osteoporosis with current pathological fracture, left humerus, sequela

M80.029A Age-related osteoporosis with current pathological fracture, unspecified humerus, initial encounter for fracture

M80.029D Age-related osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with routine healing

M80.029G Age-related osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with delayed healing

M80.029K Age-related osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with nonunion

M80.029P Age-related osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with malunion

M80.029S Age-related osteoporosis with current pathological fracture, unspecified humerus, sequela

M80.031A Age-related osteoporosis with current pathological fracture, right forearm, initial encounter for fracture

M80.031D Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with routine healing

M80.031G Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with delayed healing

M80.031K Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with nonunion

M80.031P Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with malunion

M80.031S Age-related osteoporosis with current pathological fracture, right forearm, sequela

M80.032A Age-related osteoporosis with current pathological fracture, left forearm, initial encounter for fracture

M80.032D Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with routine healing

M80.032G Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with delayed healing

M80.032K Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with nonunion

M80.032P Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with malunion

M80.032S Age-related osteoporosis with current pathological fracture, left forearm, sequela

M80.039A Age-related osteoporosis with current pathological fracture, unspecified forearm, initial encounter for fracture

M80.039D Age-related osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with routine healing

M80.039G Age-related osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with delayed healing

M80.039K Age-related osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with nonunion

M80.039P Age-related osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with malunion

M80.039S Age-related osteoporosis with current pathological fracture, unspecified forearm, sequela

M80.041A Age-related osteoporosis with current pathological fracture, right hand, initial encounter for fracture

M80.041D Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with routine healing

M80.041G Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with delayed healing

M80.041K Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with nonunion

M80.041P Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with malunion

M80.041S Age-related osteoporosis with current pathological fracture, right hand, sequela

M80.042A Age-related osteoporosis with current pathological fracture, left hand, initial encounter for fracture

M80.042D Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with routine healing

M80.042G Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with delayed healing

M80.042K Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with nonunion

M80.042P Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with malunion

M80.042S Age-related osteoporosis with current pathological fracture, left hand, sequela

M80.049A Age-related osteoporosis with current pathological fracture, unspecified hand, initial encounter for fracture

M80.049D Age-related osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with routine healing

M80.049G Age-related osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with delayed healing

M80.049K Age-related osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with nonunion

M80.049P Age-related osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with malunion

M80.049S Age-related osteoporosis with current pathological fracture, unspecified hand, sequela

M80.051A Age-related osteoporosis with current pathological fracture, right femur, initial encounter for fracture

M80.051D Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with routine healing

M80.051G Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with delayed healing

M80.051K Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with nonunion

M80.051P Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with malunion

M80.051S Age-related osteoporosis with current pathological fracture, right femur, sequela

M80.052A Age-related osteoporosis with current pathological fracture, left femur, initial encounter for fracture

M80.052D Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with routine healing

M80.052G Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with delayed healing

M80.052K Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with nonunion

M80.052P Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with malunion

M80.052S Age-related osteoporosis with current pathological fracture, left femur, sequela

M80.059A Age-related osteoporosis with current pathological fracture, unspecified femur, initial encounter for fracture

M80.059D Age-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with routine healing

M80.059G Age-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with delayed healing

M80.059K Age-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with nonunion

M80.059P Age-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with malunion

M80.059S Age-related osteoporosis with current pathological fracture, unspecified femur, sequela

M80.061A Age-related osteoporosis with current pathological fracture, right lower leg, initial encounter for fracture

M80.061D Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with routine healing

M80.061G Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with delayed healing

M80.061K Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with nonunion

M80.061P Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with malunion

M80.061S Age-related osteoporosis with current pathological fracture, right lower leg, sequela

M80.062A Age-related osteoporosis with current pathological fracture, left lower leg, initial encounter for fracture

M80.062D Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with routine healing

M80.062G Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with delayed healing

M80.062K Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with nonunion

M80.062P Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with malunion

M80.062S Age-related osteoporosis with current pathological fracture, left lower leg, sequela

M80.069A Age-related osteoporosis with current pathological fracture, unspecified lower leg, initial encounter for fracture

M80.069D Age-related osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with routine healing

M80.069G Age-related osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with delayed healing

M80.069K Age-related osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with nonunion

M80.069P Age-related osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with malunion

M80.069S Age-related osteoporosis with current pathological fracture, unspecified lower leg, sequela

M80.071A Age-related osteoporosis with current pathological fracture, right ankle and foot, initial encounter for fracture

M80.071D Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with routine healing

M80.071G Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with delayed healing

M80.071K Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with nonunion

M80.071P Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with malunion

M80.071S Age-related osteoporosis with current pathological fracture, right ankle and foot, sequela

M80.072A Age-related osteoporosis with current pathological fracture, left ankle and foot, initial encounter for fracture

M80.072D Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with routine healing

M80.072G Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with delayed healing

M80.072K Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with nonunion

M80.072P Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with malunion

M80.072S Age-related osteoporosis with current pathological fracture, left ankle and foot, sequela

M80.079A Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, initial encounter for fracture

M80.079D Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with routine healing

M80.079G Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with delayed healing

M80.079K Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with nonunion

M80.079P Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with malunion

M80.079S Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, sequela

M80.08XA Age-related osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture

M80.08XD Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with routine healing

M80.08XG Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with delayed healing

M80.08XK Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with nonunion

M80.08XP Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with malunion

M80.08XS Age-related osteoporosis with current pathological fracture, vertebra(e), sequela

M81.0 Age-related osteoporosis without current pathological fracture

M81.8 Other osteoporosis without current pathological fracture

M85.80 Other specified disorders of bone density and structure, unspecified site

M85.811 Other specified disorders of bone density and structure, right shoulder

M85.812 Other specified disorders of bone density and structure, left shoulder

M85.819 Other specified disorders of bone density and structure, unspecified shoulder

M85.821 Other specified disorders of bone density and structure, right upper arm

M85.822 Other specified disorders of bone density and structure, left upper arm

M85.829 Other specified disorders of bone density and structure, unspecified upper arm

M85.831 Other specified disorders of bone density and structure, right forearm

M85.832 Other specified disorders of bone density and structure, left forearm

M85.839 Other specified disorders of bone density and structure, unspecified forearm

M85.841 Other specified disorders of bone density and structure, right hand

M85.842 Other specified disorders of bone density and structure, left hand

M85.849 Other specified disorders of bone density and structure, unspecified hand

M85.851 Other specified disorders of bone density and structure, right thigh

M85.852 Other specified disorders of bone density and structure, left thigh

M85.859 Other specified disorders of bone density and structure, unspecified thigh

M85.861 Other specified disorders of bone density and structure, right lower leg

M85.862 Other specified disorders of bone density and structure, left lower leg

M85.869 Other specified disorders of bone density and structure, unspecified lower leg

M85.871 Other specified disorders of bone density and structure, right ankle and foot

M85.872 Other specified disorders of bone density and structure, left ankle and foot

M85.879 Other specified disorders of bone density and structure, unspecified ankle and foot

M85.88 Other specified disorders of bone density and structure, other site

M85.89 Other specified disorders of bone density and structure, multiple sites

Z87.310 Personal history of (healed) osteoporosis fracture


DENOSUMAB (XGEVAź) IS MEDICALLY NECESSARY WHEN REPORTED WITH THE FOLLOWING DIAGNOSIS CODES:

C79.51 Secondary malignant neoplasm of bone

C90.00 Multiple myeloma not having achieved remission

C90.02 Multiple myeloma in relapse

D47.02 Systemic mastocytosis

D48.0 Neoplasm of uncertain behavior of bone and articular cartilage

E83.52 Hypercalcemia



Version Effective Date: 10/01/2019
Version Issued Date: 10/03/2019
Version Reissued Date: N/A



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