2027 ICD-10-CM Diagnosis Code M84.512DPathological fracture in neoplastic disease, left shoulder, subsequent encounter for fracture with routine healing
ICD-10-CM Codes›M00–M99›M80-M85›M84
- Billable — Valid for Submission
- 7th Character D — Subsequent Encounter
- Chronic Condition
M84.512D is a billable ICD-10-CM diagnosis code for pathological fracture in neoplastic disease, left shoulder, subsequent encounter for fracture with routine healing. The 7th character D means subsequent encounter for fracture with routine healing, used during routine care in the healing or recovery phase. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 559 through 561. Coders also document this condition as neoplasm of left clavicle. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pathological fracture, subsequent encounter.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Neoplasm of left clavicle
- Neoplasm of left scapula
- Pathologic fracture of clavicle at site of neoplasm
- Pathologic fracture of scapula at site of neoplasm
- Pathological fracture of clavicle
- Pathological fracture of left clavicle
- Pathological fracture of left clavicle at site of neoplasm
- Pathological fracture of left scapula
- Pathological fracture of left scapula at site of neoplasm
- Pathological fracture of scapula
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to M84.512D: its own notes plus those printed at M84.5, M84, and Chapter 13. A note printed at a category, block or chapter applies to every code under it.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- traumatic fracture of bone-see fracture, by site
- arthropathic psoriasis (L40.5-)
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- compartment syndrome (traumatic) (T79.A-)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
- underlying neoplasm
Notes
General instructions on how these codes are used.
- Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
7th Character
Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.
- The appropriate 7th character is to be added to each code from subcategory M84.5:
- Ainitial encounter for fracture
- Dsubsequent encounter for fracture with routine healing this code
- Gsubsequent encounter for fracture with delayed healing
- Ksubsequent encounter for fracture with nonunion
- Psubsequent encounter for fracture with malunion
- Ssequela
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name M84.512D, its category, or a range that includes it.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Fractures
A fracture is a break in a bone. Fractures are usually caused by injuries. Since they can sometimes be serious, it's important to get medical care right away if you think you have a fracture.
The full article covers:
- What is a fracture?
- What are the different types of fractures?
- What causes fractures?
- What are the symptoms of a fracture?
- How are fractures diagnosed?
- What are the treatments for fractures?
- Can fractures be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert M84.512D to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M84.512DOverview
Is M84.512D (Pathological fracture in neoplastic disease, left shoulder) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report pathological fracture in neoplastic disease, left shoulder, subsequent encounter for fracture with routine healing on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character D in M84.512D mean?
The final character D marks a subsequent encounter: use it for routine care while the pathological fracture in neoplastic disease, left shoulder is healing, after active treatment has ended. In this category the CMS Tabular List defines D as "subsequent encounter for fracture with routine healing".
What MS-DRG does M84.512D group to?
When pathological fracture in neoplastic disease, left shoulder, subsequent encounter for fracture with routine healing is the principal diagnosis on an inpatient stay, it groups to MS-DRG 559, 561, 560, with relative weights from 0.8258 to 1.8087 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of M84.512D?
Under the General Equivalence Mappings, pathological fracture in neoplastic disease, left shoulder, subsequent encounter for fracture with routine healing converts to ICD-9-CM V54.21 (aftercare path fx up arm). The mapping is approximate, so confirm the match fits the documentation.
