Version 2024

2024 ICD-10-CM Diagnosis Code M84.61

Pathological fracture in other disease, shoulder

ICD-10-CM Code:
M84.61
ICD-10 Code for:
Pathological fracture in other disease, shoulder
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)

M84.61 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 in other disease, shoulder. 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.

Specific Coding Applicable to Pathological fracture in other disease, shoulder

Non-specific codes like M84.61 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 in other disease, shoulder:

  • M84.611 for Pathological fracture in other disease, right shoulder - NON-BILLABLE CODE

  • Use M84.611A for initial encounter for fracture - BILLABLE CODE

  • Use M84.611D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.611G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.611K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.611P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.611S for sequela - BILLABLE CODE

  • M84.612 for Pathological fracture in other disease, left shoulder - NON-BILLABLE CODE

  • Use M84.612A for initial encounter for fracture - BILLABLE CODE

  • Use M84.612D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.612G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.612K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.612P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.612S for sequela - BILLABLE CODE

  • M84.619 for Pathological fracture in other disease, unspecified shoulder - NON-BILLABLE CODE

  • Use M84.619A for initial encounter for fracture - BILLABLE CODE

  • Use M84.619D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.619G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.619K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.619P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.619S for sequela - BILLABLE CODE

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

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]

Shoulder Injuries and Disorders

Your shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone). Your shoulders are the most movable joints in your body. They can also be unstable because the ball of the upper arm is larger than the shoulder socket that holds it. To remain in a stable or normal position, the shoulder must be anchored by muscles, tendons, and ligaments.

Because your shoulder can be unstable, it can be easily injured. Common problems include:

  • Sprains and strains
  • Dislocations
  • Separations
  • Tendinitis
  • Bursitis
  • Torn rotator cuffs
  • Frozen shoulder
  • Fractures (broken bones)
  • Arthritis

Health care providers diagnose shoulder problems by using your medical history, a physical exam, and imaging tests.

Often, the first treatment for shoulder problems is RICE. This stands for Rest, Ice, Compression, and Elevation. Other treatments include exercise and medicines to reduce pain and swelling. If those don't work, you may need surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases


[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.