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  2. ICD-10-CM Codes
  3. M00–M99
  4. M80-M85
  5. M84
  6. 2024 ICD-10-CM Code M84.4
Version 2024
Non-Billable Code

2024 ICD-10-CM Diagnosis Code M84.4

Pathological fracture, not elsewhere classified

ICD-10-CM Code:
M84.4
ICD-10 Code for:
Pathological fracture, not elsewhere classified
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)

M84.4 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, not elsewhere classified. 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, not elsewhere classified

Non-specific codes like M84.4 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, not elsewhere classified:

  • M84.40 for Pathological fracture, unspecified site - NON-BILLABLE CODE

  • 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

  • M84.41 for Pathological fracture, shoulder - NON-BILLABLE CODE

  • M84.411 for Pathological fracture, right shoulder - NON-BILLABLE CODE

  • Use M84.411A for initial encounter for fracture - BILLABLE CODE

  • Use M84.411D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.411G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.411K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.411P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.411S for sequela - BILLABLE CODE

  • M84.412 for Pathological fracture, left shoulder - NON-BILLABLE CODE

  • Use M84.412A for initial encounter for fracture - BILLABLE CODE

  • Use M84.412D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.412G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.412K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.412P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.412S for sequela - BILLABLE CODE

  • M84.419 for Pathological fracture, unspecified shoulder - NON-BILLABLE CODE

  • Use M84.419A for initial encounter for fracture - BILLABLE CODE

  • Use M84.419D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.419G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.419K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.419P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.419S for sequela - BILLABLE CODE

  • M84.42 for Pathological fracture, humerus - NON-BILLABLE CODE

  • M84.421 for Pathological fracture, right humerus - NON-BILLABLE CODE

  • Use M84.421A for initial encounter for fracture - BILLABLE CODE

  • Use M84.421D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.421G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.421K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.421P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.421S for sequela - BILLABLE CODE

  • M84.422 for Pathological fracture, left humerus - NON-BILLABLE CODE

  • Use M84.422A for initial encounter for fracture - BILLABLE CODE

  • Use M84.422D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.422G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.422K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.422P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.422S for sequela - BILLABLE CODE

  • M84.429 for Pathological fracture, unspecified humerus - NON-BILLABLE CODE

  • Use M84.429A for initial encounter for fracture - BILLABLE CODE

  • Use M84.429D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.429G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.429K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.429P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.429S for sequela - BILLABLE CODE

  • M84.43 for Pathological fracture, ulna and radius - NON-BILLABLE CODE

  • M84.431 for Pathological fracture, right ulna - NON-BILLABLE CODE

  • Use M84.431A for initial encounter for fracture - BILLABLE CODE

  • Use M84.431D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.431G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.431K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.431P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.431S for sequela - BILLABLE CODE

  • M84.432 for Pathological fracture, left ulna - NON-BILLABLE CODE

  • Use M84.432A for initial encounter for fracture - BILLABLE CODE

  • Use M84.432D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.432G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.432K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.432P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.432S for sequela - BILLABLE CODE

  • M84.433 for Pathological fracture, right radius - NON-BILLABLE CODE

  • Use M84.433A for initial encounter for fracture - BILLABLE CODE

  • Use M84.433D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.433G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.433K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.433P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.433S for sequela - BILLABLE CODE

  • M84.434 for Pathological fracture, left radius - NON-BILLABLE CODE

  • Use M84.434A for initial encounter for fracture - BILLABLE CODE

  • Use M84.434D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.434G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.434K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.434P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.434S for sequela - BILLABLE CODE

  • M84.439 for Pathological fracture, unspecified ulna and radius - NON-BILLABLE CODE

  • Use M84.439A for initial encounter for fracture - BILLABLE CODE

  • Use M84.439D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.439G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.439K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.439P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.439S for sequela - BILLABLE CODE

  • M84.44 for Pathological fracture, hand and fingers - NON-BILLABLE CODE

  • M84.441 for Pathological fracture, right hand - NON-BILLABLE CODE

  • Use M84.441A for initial encounter for fracture - BILLABLE CODE

  • Use M84.441D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.441G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.441K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.441P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.441S for sequela - BILLABLE CODE

  • M84.442 for Pathological fracture, left hand - NON-BILLABLE CODE

  • Use M84.442A for initial encounter for fracture - BILLABLE CODE

  • Use M84.442D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.442G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.442K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.442P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.442S for sequela - BILLABLE CODE

  • M84.443 for Pathological fracture, unspecified hand - NON-BILLABLE CODE

  • Use M84.443A for initial encounter for fracture - BILLABLE CODE

  • Use M84.443D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.443G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.443K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.443P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.443S for sequela - BILLABLE CODE

  • M84.444 for Pathological fracture, right finger(s) - NON-BILLABLE CODE

  • Use M84.444A for initial encounter for fracture - BILLABLE CODE

  • Use M84.444D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.444G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.444K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.444P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.444S for sequela - BILLABLE CODE

  • M84.445 for Pathological fracture, left finger(s) - NON-BILLABLE CODE

  • Use M84.445A for initial encounter for fracture - BILLABLE CODE

  • Use M84.445D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.445G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.445K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.445P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.445S for sequela - BILLABLE CODE

  • M84.446 for Pathological fracture, unspecified finger(s) - NON-BILLABLE CODE

  • Use M84.446A for initial encounter for fracture - BILLABLE CODE

  • Use M84.446D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.446G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.446K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.446P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.446S for sequela - BILLABLE CODE

  • M84.45 for Pathological fracture, femur and pelvis - NON-BILLABLE CODE

  • M84.451 for Pathological fracture, right femur - NON-BILLABLE CODE

  • Use M84.451A for initial encounter for fracture - BILLABLE CODE

  • Use M84.451D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.451G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.451K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.451P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.451S for sequela - BILLABLE CODE

  • M84.452 for Pathological fracture, left femur - NON-BILLABLE CODE

  • Use M84.452A for initial encounter for fracture - BILLABLE CODE

  • Use M84.452D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.452G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.452K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.452P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.452S for sequela - BILLABLE CODE

  • M84.453 for Pathological fracture, unspecified femur - NON-BILLABLE CODE

  • Use M84.453A for initial encounter for fracture - BILLABLE CODE

  • Use M84.453D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.453G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.453K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.453P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.453S for sequela - BILLABLE CODE

  • M84.454 for Pathological fracture, pelvis - NON-BILLABLE CODE

  • Use M84.454A for initial encounter for fracture - BILLABLE CODE

  • Use M84.454D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.454G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.454K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.454P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.454S for sequela - BILLABLE CODE

  • M84.459 for Pathological fracture, hip, unspecified - NON-BILLABLE CODE

  • Use M84.459A for initial encounter for fracture - BILLABLE CODE

  • Use M84.459D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.459G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.459K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.459P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.459S for sequela - BILLABLE CODE

  • M84.46 for Pathological fracture, tibia and fibula - NON-BILLABLE CODE

  • M84.461 for Pathological fracture, right tibia - NON-BILLABLE CODE

  • Use M84.461A for initial encounter for fracture - BILLABLE CODE

  • Use M84.461D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.461G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.461K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.461P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.461S for sequela - BILLABLE CODE

  • M84.462 for Pathological fracture, left tibia - NON-BILLABLE CODE

  • Use M84.462A for initial encounter for fracture - BILLABLE CODE

  • Use M84.462D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.462G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.462K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.462P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.462S for sequela - BILLABLE CODE

  • M84.463 for Pathological fracture, right fibula - NON-BILLABLE CODE

  • Use M84.463A for initial encounter for fracture - BILLABLE CODE

  • Use M84.463D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.463G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.463K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.463P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.463S for sequela - BILLABLE CODE

  • M84.464 for Pathological fracture, left fibula - NON-BILLABLE CODE

  • Use M84.464A for initial encounter for fracture - BILLABLE CODE

  • Use M84.464D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.464G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.464K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.464P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.464S for sequela - BILLABLE CODE

  • M84.469 for Pathological fracture, unspecified tibia and fibula - NON-BILLABLE CODE

  • Use M84.469A for initial encounter for fracture - BILLABLE CODE

  • Use M84.469D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.469G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.469K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.469P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.469S for sequela - BILLABLE CODE

  • M84.47 for Pathological fracture, ankle, foot and toes - NON-BILLABLE CODE

  • M84.471 for Pathological fracture, right ankle - NON-BILLABLE CODE

  • Use M84.471A for initial encounter for fracture - BILLABLE CODE

  • Use M84.471D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.471G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.471K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.471P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.471S for sequela - BILLABLE CODE

  • M84.472 for Pathological fracture, left ankle - NON-BILLABLE CODE

  • Use M84.472A for initial encounter for fracture - BILLABLE CODE

  • Use M84.472D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.472G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.472K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.472P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.472S for sequela - BILLABLE CODE

  • M84.473 for Pathological fracture, unspecified ankle - NON-BILLABLE CODE

  • Use M84.473A for initial encounter for fracture - BILLABLE CODE

  • Use M84.473D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.473G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.473K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.473P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.473S for sequela - BILLABLE CODE

  • M84.474 for Pathological fracture, right foot - NON-BILLABLE CODE

  • Use M84.474A for initial encounter for fracture - BILLABLE CODE

  • Use M84.474D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.474G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.474K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.474P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.474S for sequela - BILLABLE CODE

  • M84.475 for Pathological fracture, left foot - NON-BILLABLE CODE

  • Use M84.475A for initial encounter for fracture - BILLABLE CODE

  • Use M84.475D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.475G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.475K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.475P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.475S for sequela - BILLABLE CODE

  • M84.476 for Pathological fracture, unspecified foot - NON-BILLABLE CODE

  • Use M84.476A for initial encounter for fracture - BILLABLE CODE

  • Use M84.476D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.476G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.476K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.476P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.476S for sequela - BILLABLE CODE

  • M84.477 for Pathological fracture, right toe(s) - NON-BILLABLE CODE

  • Use M84.477A for initial encounter for fracture - BILLABLE CODE

  • Use M84.477D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.477G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.477K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.477P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.477S for sequela - BILLABLE CODE

  • M84.478 for Pathological fracture, left toe(s) - NON-BILLABLE CODE

  • Use M84.478A for initial encounter for fracture - BILLABLE CODE

  • Use M84.478D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.478G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.478K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.478P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.478S for sequela - BILLABLE CODE

  • M84.479 for Pathological fracture, unspecified toe(s) - NON-BILLABLE CODE

  • Use M84.479A for initial encounter for fracture - BILLABLE CODE

  • Use M84.479D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.479G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.479K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.479P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.479S for sequela - BILLABLE CODE

  • M84.48 for Pathological fracture, other site - NON-BILLABLE CODE

  • Use M84.48XA for initial encounter for fracture - BILLABLE CODE

  • Use M84.48XD for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use M84.48XG for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use M84.48XK for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use M84.48XP for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use M84.48XS for sequela - BILLABLE CODE

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.


Inclusion Terms

Inclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
  • Chronic fracture
  • Pathological fracture NOS

Type 1 Excludes

Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.

Type 2 Excludes

Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
  • personal history of healed pathological fracture Z87.311

7th Character Note

7th Character Note
Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
  • The appropriate 7th character is to be added to each code from subcategory M84.4:

7th Character

7th Character
Indicates that a seventh character is to be assigned to codes in a subcategory.
  • A - initial encounter for fracture
  • D - subsequent encounter for fracture with routine healing
  • G - subsequent encounter for fracture with delayed healing
  • K - subsequent encounter for fracture with nonunion
  • P - subsequent encounter for fracture with malunion
  • S - sequela

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.