Appendix - Supplemental information for determining the presence of FRAX risk factors

Table i. ICD-9 Codes Used to Identify Secondary Osteoporosis

Indication / ICD-9 Code / Description
Type 1 Diabetes / 250.01 / Diabetes mellitus without complication type 1 not stated as uncontrolled
250.03 / Diabetes mellitus without complication type 1 uncontrolled
250.11 / Diabetes with ketoacidosis, type I [juvenile type], not stated as uncontrolled
250.13 / Diabetes with ketoacidosis, type I [juvenile type], uncontrolled
250.21 / Diabetes with hyperosmolarity, type I [juvenile type], not stated as uncontrolled
250.23 / Diabetes with hyperosmolarity, type I [juvenile type], uncontrolled
250.31 / Diabetes with other coma, type I [juvenile type], not stated as uncontrolled
250.33 / Diabetes with other coma, type I [juvenile type], uncontrolled
250.41 / Diabetes with renal manifestations, type I [juvenile type], not stated as uncontrolled
250.43 / Diabetes with renal manifestations, type I [juvenile type], uncontrolled
250.51 / Diabetes with ophthalmic manifestations, type I [juvenile type], not stated as uncontrolled
250.53 / Diabetes with ophthalmic manifestations, type I [juvenile type], uncontrolled
250.61 / Diabetes with neurological manifestations, type I [juvenile type], not stated as uncontrolled
250.63 / Diabetes with neurological manifestations, type I [juvenile type], uncontrolled
250.71 / Diabetes with peripheral circulatory disorders, type I [juvenile type], not stated as uncontrolled
250.73 / Diabetes with peripheral circulatory disorders, type I [juvenile type], uncontrolled
250.81 / Diabetes with other specified manifestations, type I [juvenile type], not stated as uncontrolled
250.83 / Diabetes with other specified manifestations, type I [juvenile type], uncontrolled
250.91 / Diabetes with unspecified complication, type I [juvenile type], not stated as uncontrolled
250.93 / Diabetes with unspecified complication, type I [juvenile type], uncontrolled
Osteogenesisimperfecta / 756.51 / Osteogenesisimperfecta
Hyperthyroidism / 242.01 / Toxic diffuse goiter with mention of thyrotoxic crisis or storm
242.11 / Toxic uninodular goiter with mention of thyrotoxic crisis or storm
242.21 / Toxic multinodular goiter with mention of thyrotoxic crisis or storm
242.31 / Toxic nodular goiter, unspecified type, with mention of thyrotoxic crisis or storm
242.41 / Thyrotoxicosis from ectopic thyroid nodule with mention of thyrotoxic crisis or storm
242.81 / Thyrotoxicosis of other specified origin with mention of thyrotoxic crisis or storm
242.91 / Thyrotoxicosis without mention of goiter or other cause, with mention of thyrotoxic crisis or storm
Female hypogonadism / 256.3 / Other ovarian failure
Chronic malnutrition / 260 / Kwashiorkor
261 / Nutritional marasmus
262 / Other severe, protein-calorie malnutrition
263 / Other and unspecified protein-calorie malnutrition
263.* / Sub codes of 263 including 263.0, 263.1, 263.2, 263.8, and 263.9
783 / Symptoms concerning nutrition, metabolism, and development
783.* / Sub codes of 783 including 783.0, 783.1, 783.2, 783.3, 783.4, 783.5, 783.6, 783.7, and 783.9
783.** / 2 digit sub codes of 783 including 783.21, 783.22, 783.40, 783.41, 783.42, and 783.43
Malabsorption / 579 / Intestinal malabsorption
579.* / Sub codes of 579 including 579.0, 579.1, 579.2, 579.3, 579.4, 579.8, and 579.9
271.3 / Intestinal disaccharidase deficiencies and disaccharide malabsorption
Chronic liver disease / 070.** / 2 digit sub codes of viral hepatitis (070) and includes 070.20-070.23, 070.30-070.33, 070.41-070.44, 070.49, 070.51-070.54, 070.59, 070.70, and 070.71
571.** / 2 digit sub codes of chronic liver disease and cirrhosis (571) and includes 571.40-571.42, and 571.49
Eating disorders / 307.5 / Other and unspecified disorders of eating includes 307.50 (eating disorder unspecified), 307.51 (Bulimia nervosa), 307.52 (Pica), 307.53 (Rumination disorder), 307.54 (Psychogenic vomiting), and 307.59 (Other disorders of eating)

Table ii. List of oral corticosteroids and conversion factor to calculate dose equivalent to prednisolone 5mg

Drug / Dose (mg) / Conversion Factor
Betamethasone / 0.6 / 0.12
Dexamethasone / 0.75 / 0.15
Fludracortisone / 1.3 / 0.26
Methylprednisolone / 4 / 0.8
Triamcinolone / 4 / 0.8
Prednisone / 5 / 1
Hydrocortisone / 20 / 4
Cortisone / 25 / 5

Table iii. ICD-9 Codes Used to Identify Fragility Fractures

Code / Description
Fracture of the Vertebra
805.0* / Closed fracture of cervical vertebra w/o spinal cord injury
805.2 / Closed fracture of dorsal (thoracic) vertebra without spinal cord injury
805.4 / Closed fracture of lumbar vertebra without spinal cord injury
805.6 / Closed fracture of sacrum and coccyx without spinal cord injury
805.8 / Closed fracture of unspecified part of vertebral column without spinal cord injury
905.1 / Late effect of fracture of spine and trunk without spinal cord lesion
Fracture of the Hip/Pelvis
808.0 / Closed fracture of acetabulum
808.2 / Closed fracture of pubis
808.4* / Closed fracture of other specified part of pelvis
808.8 / Unspecified closed fracture of pelvis
820.0* / Transcervical fracture closed
820.2* / Pertrochanteric fracture of femur closed
820.8 / Fracture of unspecified part of neck of femur closed
905.3 / Late effect of fracture of neck of femur
Fracture of the Humerus
812.0* / Closed fracture of the upper end of the humerus
812.2* / Closed fracture of the humerus shaft (unspecified)
812.4* / Closed fracture of the lower end of the humerus
Fracture of the Wrist
813.0* / Fracture of the upper end of radius and ulna closed
813.2* / Fracture of the shaft of radius or ulna closed
813.4* / Fracture of lower end of radius and ulna closed
813.8* / Fracture of unspecified part of radius with ulna closed
814.0* / Closed fractures of carpal bones
Fracture of the Femur
820.0* / Transcervical fracture closed
820.2* / Pertrochanteric fracture of femur closed
820.8 / Fracture of unspecified part of neck of femur closed
821.0* / Fracture of shaft or unspecified part of femur closed
821.2* / Fracture of lower end of femur closed
Fracture of Patella
822.0 / Closed fracture of patella
Fracture of Tibia and Fibula
823.0* / Fracture of upper end of tibia and fibula closed
823.2* / Fracture of shaft of tibia and fibula closed
823.4* / Torus fracture of tibia and fibula
823.8* / Fracture of unspecified part of tibia and fibula closed
Fracture of the Ankle
824.0 / Fracture of medial malleolus closed
824.2 / Fracture of lateral malleolus closed
824.4 / Bimalleolar fracture closed
824.6 / Trimalleolar fracture closed
824.8 / Unspecified fracture of ankle closed
Other Fractures
828.0 / Multiple fractures involving both lower limbs, lower with upper limb and lower limb(s) with rib(s) and sternum closed

*Includes sub codes

Table iv. CPT Codes Used to Identify Fragility Fractures

Location / Codes
Vertebra / 22305, 22310, 22315, 22325-22328
Hip/Pelvis / 27193, 27194, 27200, 27202, 27215-27218, 27220, 27222, 27226-27228, 27230, 27232, 27235, 27236, 27238, 27240, 27244-27246, 27248, 27267-27269
Forearm/Wrist / 25500, 25505, 25515, 25520, 25525, 25526, 25530, 25535, 25545, 25560, 25565, 25574, 25575, 25600, 25605-25609, 25622, 25624, 25628, 25630, 25635, 25645, 25650-25652, 25600, 25605-25609
Elbow/Upper Arm / 24500, 24505, 24515, 24516, 24530, 24535, 24538, 24545, 24546, 24560, 24565, 24566, 24575-24577, 24579, 24582, 24586, 24587, 24665, 24666, 24670, 24675, 24685
Ankle/Proximal Humerus / 23600, 23605, 23615, 23616, 23620, 23625, 23630, 23665, 23670, 23675, 23680, 27760, 27762, 27766, 27786, 27788, 27792, 27808, 27810, 27814, 27816, 27818, 27822, 27823
Femur/Knee / 27500-27503, 27506-27511, 27513, 27514, 27530, 27532, 27535, 27536, 27538, 27540
Lower Leg/Ankle / 27750, 27752, 27756, 27758, 27759

Table v. ICD-9 Codes Used to Identify Trauma

E800-848 / E909-909
E881-884 / E916-928

Table vi. ICD-9 Codes Used to Identify Rheumatoid Arthritis Diagnosis

Code / Description
714 / Rheumatoid arthritis and other inflammatory polyarthropathies
714.0 / Rheumatoid arthritis
714.1 / Felty's syndrome (Rheumatoid arthritis with splenoadenomegaly and leukopenia)
714.2 / Other rheumatoid arthritis with visceral or systemic involvement
714.4 / Chronic post-rheumatic arthropathy

Table vii. CPT Codes Used to Identify Rheumatoid Arthritis

Code / Description
3470F / Rheumatoid arthritis (RA) disease activity, low (RA)
3471F / Rheumatoid arthritis (RA) disease activity, moderate (RA)
3472F / Rheumatoid arthritis (RA) disease activity, high (RA)
3475F / Disease prognosis for rheumatoid arthritis assessed, poor prognosis documented (RA)
3476F / Disease prognosis for rheumatoid arthritis assessed, good prognosis documented (RA)
4195F / Patient receiving first-time biologic disease modifying anti-rheumatic drug therapy for rheumatoid arthritis (RA)

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