2027 ICD-10-CM Diagnosis Code M84.629DPathological fracture in other disease, unspecified humerus, subsequent encounter for fracture with routine healing
M84.629D is a billable ICD-10-CM diagnosis code for pathological fracture in other disease, unspecified humerus, 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pathological fracture, subsequent encounter.
Code Identity
Code Classification
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to M84.629D: its own notes plus those printed at M84.6, M84, and Chapter 13. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
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 condition
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 M84.6:
- 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 M84.629D, its category, or a range that includes it.
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.
Read the full article at MedlinePlus
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Convert M84.629D to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M84.629DOverview
Is M84.629D (Pathological fracture in other disease, unspecified humerus) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report pathological fracture in other disease, unspecified humerus, 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 M84.629D mean?
The final character D marks a subsequent encounter: use it for routine care while the pathological fracture in other disease, unspecified humerus 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 M84.629D group to?
When pathological fracture in other disease, unspecified humerus, 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.
Can M84.629D be reported with a code from M80?
Not as a rule. The Excludes1 note at M84.6, which applies to M84.629D, lists "pathological fracture in osteoporosis (M80.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What is the ICD-9 equivalent of M84.629D?
Under the General Equivalence Mappings, pathological fracture in other disease, unspecified humerus, 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.
