2026 ICD-10-CM Diagnosis Code M84.475DPathological fracture, left foot, subsequent encounter for fracture with routine healing

ICD-10-CM Codes›M00–M99›M80-M85›M84

ICD-10-CM M84.475D
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

M84.475D is a billable ICD-10-CM diagnosis code for pathological fracture, left foot, subsequent encounter for fracture with routine healing. The 7th character D marks it as a subsequent encounter code, used during routine care in the healing or recovery phase. 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 of left foot. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pathological fracture, subsequent encounter.

Code Identity

ICD-10-CM Code
M84.475D
Billable Status
Yes — Valid for Submission
Code Describes
Pathological fracture, left foot, subsequent encounter for fracture with routine healing
Short Description
Pathological fracture, left foot, subs for fx w routn heal
Parent Code
M84.475
Pathological fracture, left foot

Code Classification

ChapterM00–M99Diseases of the musculoskeletal system and connective tissue
SectionM80-M85Disorders of bone density and structure
CategoryM84Disorder of continuity of bone
This CodeM84.475DPathological fracture, left foot, subsequent encounter for fracture with routine healing

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Pathological fracture of left foot

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

Foot Injuries and Disorders

Each of your feet has 26 bones, 33 joints, and more than 100 tendons, muscles, and ligaments. No wonder a lot of things can go wrong. Here are a few common problems:

Read the full article at MedlinePlus

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

Convert M84.475D to ICD-9-CMHistory

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

ICD-9-CM
V54.26 Aftrcare path fx low leg
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 M84.475DOverview

Is M84.475D (Pathological fracture, left foot) a billable code?

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

What does the 7th character D in M84.475D mean?

The final character D marks a subsequent encounter: use it for routine care while the pathological fracture, left foot is healing, after active treatment has ended.

What MS-DRG does M84.475D group to?

When pathological fracture, left foot, subsequent encounter for fracture with routine 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 M84.475D?

Under the General Equivalence Mappings, pathological fracture, left foot, subsequent encounter for fracture with routine healing converts to ICD-9-CM V54.26 (aftrcare path fx low leg). 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.