2026 ICD-10-CM Diagnosis Code M84.429GPathological fracture, unspecified humerus, subsequent encounter for fracture with delayed healing

ICD-10-CM Codes›M00–M99›M80-M85›M84

ICD-10-CM M84.429G
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

M84.429G is a billable ICD-10-CM diagnosis code for pathological fracture, unspecified humerus, subsequent encounter for fracture with delayed healing. The 7th character G reports a subsequent encounter for a fracture that is healing more slowly than expected. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 559 through 561. Coders also document this condition as pathological fracture - upper arm. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pathological fracture, subsequent encounter.

Code Identity

ICD-10-CM Code
M84.429G
Billable Status
Yes — Valid for Submission
Code Describes
Pathological fracture, unspecified humerus, subsequent encounter for fracture with delayed healing
Short Description
Path fracture, unsp humerus, subs for fx w delay heal
Parent Code
M84.429
Pathological fracture, unspecified humerus

Code Classification

ChapterM00–M99Diseases of the musculoskeletal system and connective tissue
SectionM80-M85Disorders of bone density and structure
CategoryM84Disorder of continuity of bone
This CodeM84.429GPathological fracture, unspecified humerus, subsequent encounter for fracture with delayed healing

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Pathological fracture - upper arm

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MUS015
Pathological fracture, subsequent encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Arm Injuries and Disorders

Of the 206 bones in your body, three of them are in your arm: the humerus, radius, and ulna. Your arms are also made up of muscles, joints, tendons, and other connective tissue. Injuries to any of these parts of the arm can occur during sports, a fall, or an accident.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert M84.429G to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
V54.21 Aftercare path fx up arm
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About M84.429GOverview

Is M84.429G (Pathological fracture, unspecified humerus) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report pathological fracture, unspecified humerus, subsequent encounter for fracture with delayed healing on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character G in M84.429G mean?

The final character G reports a subsequent encounter where the pathological fracture, unspecified humerus is healing more slowly than expected.

What MS-DRG does M84.429G group to?

When pathological fracture, unspecified humerus, subsequent encounter for fracture with delayed healing is the principal diagnosis on an inpatient stay, it groups to MS-DRG 559, 560, 561, with relative weights from 0.8039 to 1.8649 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of M84.429G?

Under the General Equivalence Mappings, pathological fracture, unspecified humerus, subsequent encounter for fracture with delayed healing converts to ICD-9-CM V54.21 (aftercare path fx up arm). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.