Current RMA Instruments

Changes from previous Instruments

SOP Bulletin 178

ICD Coding

• ICD-9-CM Codes: 733.0
• ICD-10-AM Codes: M80.0-M80.9, M81.0-M81.9, M82.0, M82.1, M82.8

Brief description

This is general (systemic) low bone density.  This low bone density can be incidentally discovered by bone imaging, or discovered on investigation of a pathological bone fracture resulting from relatively trivial application of forces to the bone.

Confirming the diagnosis

Confirmation of the diagnosis requires:

• bone densitometry results, or
• radiological evidence of a minimal trauma fracture associated with contemporary or previous imaging evidence of reduced bone density at that site.

The threshold level for the determination of osteoporosis using bone densitometry is a measurement = 2.5 standard deviations below the mean compared to normal young adult sex-matched controls. This is the T-score rather than the associated Z-score, which is for age-matched controls.

The relevant medical specialist is an endocrinologist.

Additional diagnoses covered by SOP

• Nil

Conditions excluded from SOP

• A normal traumatic fracture* - fracture SOP
• Osteomalacia^#
• Osteopaenia, declared not a disease by RMA - NIF
• Reduced bone density not meeting the minimum decrease in bone density requirement in the SOP - NIF

* another SOP applies

^# non-SOP condition

Clinical onset

This is a threshold diagnosis.  Clinical onset will be when bone densitometry results first showed the required decrease or when an osteoporotic fracture first occurred.

Clinical worsening

For worsening there would need to be evidence of an accelerated decrease in bone density, beyond that which occurs normally with age.