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  6. 2024 ICD-10-CM Code M84.40

2024 ICD-10-CM Diagnosis Code M84.40

Pathological fracture, unspecified site

ICD-10-CM Code:
M84.40
ICD-10 Code for:
Pathological fracture, unspecified site
Is Billable?
Not Valid for Submission
Code Navigator:

Code Classification

  • Diseases of the musculoskeletal system and connective tissue
    (M00–M99)
    • Disorders of bone density and structure
      (M80-M85)
      • Disorder of continuity of bone
        (M84)

M84.40 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of pathological fracture, unspecified site. The code is not specific and is NOT valid for the year 2024 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Unspecified diagnosis codes like M84.40 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Specific Coding Applicable to Pathological fracture, unspecified site

Non-specific codes like M84.40 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for pathological fracture, unspecified site:

  • Use M84.40XA for initial encounter for fracture - BILLABLE CODE

  • Use M84.40XD for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.40XG for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.40XK for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.40XP for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.40XS for sequela - BILLABLE CODE

Patient Education


Fractures

A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open or compound fracture. Fractures commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the bone.

Symptoms of a fracture are:

  • Intense pain
  • Deformity - the limb looks out of place
  • Swelling, bruising, or tenderness around the injury
  • Numbness and tingling
  • Problems moving a limb

You need to get medical care right away for any fracture. An x-ray can tell if your bone is broken. You may need to wear a cast or splint. Sometimes you need surgery to put in plates, pins or screws to keep the bone in place.


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.