2024 ICD-10-CM Diagnosis Code M84.559K

Pathological fracture in neoplastic disease, hip, unspecified, subsequent encounter for fracture with nonunion

ICD-10-CM Code:
M84.559K
ICD-10 Code for:
Path fx in neopltc dis, hip, unsp, subs for fx w nonunion
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Chronic
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)

M84.559K is a billable diagnosis code used to specify a medical diagnosis of pathological fracture in neoplastic disease, hip, unspecified, subsequent encounter for fracture with nonunion. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

M84.559K is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like pathological fracture in neoplastic disease hip unspecified for fracture with nonunion. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.

Unspecified diagnosis codes like M84.559K 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.

Clinical Classification

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

  • Unspecified codes - Unspecified codes exist in the ICD-10-CM classification for circumstances when documentation in the medical record does not provide the level of detail needed to support reporting a more specific code. However, in the inpatient setting, there should generally be very limited and rare circumstances for which the laterality (right, left, bilateral) of a condition is unable to be documented and reported. The following pages contain the list of unspecified ICD-10-CM diagnosis codes for which there is a more specific code to identify laterality (right, left, bilateral) within that code family.

Convert M84.559K to ICD-9-CM

  • ICD-9-CM Code: 733.82 - Nonunion of fracture
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original 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]

Hip Injuries and Disorders

Your hip is the joint where your femur (thigh bone) meets your pelvis (hip bone). There are two main parts: a ball at the end of the femur, which fits in a socket in the pelvis. Your hip is known as a ball-and-socket joint. This is because you have a ball at the end of your femur, and it fits into a socket in your pelvis. This makes your hips very stable and allows for a wide range of motion. When they are healthy, it takes great force to hurt them. However, playing sports, running, overuse, or falling can sometimes lead to hip injuries such as:

  • Strains
  • Bursitis
  • Dislocations
  • Fractures (broken bones)

Certain diseases also lead to hip injuries or problems. Osteoarthritis can cause pain and limited motion. Osteoporosis of the hip causes weak bones that break easily. Both of these are common in older people.

Another problem is hip dysplasia, where the ball at the end of the femur is loose in the hip socket. It can cause hip dislocation. Babies who have hip dysplasia are usually born with it, but sometimes they develop it later.

Treatment for hip disorders may include rest, medicines, physical therapy, or surgery, including hip replacement.


[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.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.