2026 ICD-10-CM Diagnosis Code M84.522APathological fracture in neoplastic disease, left humerus, initial encounter for fracture
ICD-10-CM Codes›M00–M99›M80-M85›M84
- Billable — Valid for Submission
- 7th Character A — Initial Encounter
- Chronic Condition
M84.522A is a billable ICD-10-CM diagnosis code for pathological fracture in neoplastic disease, left humerus, initial encounter for fracture. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 542 through 544. Coders also document this condition as pathological fracture - upper arm. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Conditions due to neoplasm or the treatment of neoplasm; and Pathological fracture, initial encounter.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Pathological fracture - upper arm
- Pathological fracture of left humerus
- Pathological fracture of left humerus due to neoplasm
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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.
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Convert M84.522A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M84.522AOverview
Is M84.522A (Pathological fracture in neoplastic disease, left humerus) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report pathological fracture in neoplastic disease, left humerus, initial encounter for fracture on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in M84.522A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for pathological fracture in neoplastic disease, left humerus, such as an emergency visit or first evaluation.
What MS-DRG does M84.522A group to?
When pathological fracture in neoplastic disease, left humerus, initial encounter for fracture is the principal diagnosis on an inpatient stay, it groups to MS-DRG 542, 543, 544, with relative weights from 0.7546 to 1.7665 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of M84.522A?
Under the General Equivalence Mappings, pathological fracture in neoplastic disease, left humerus, initial encounter for fracture converts to ICD-9-CM 733.11 (path fx humerus). The mapping is approximate, so confirm the match fits the documentation.
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.
