2027 ICD-10-CM Diagnosis Code M84.754AComplete transverse atypical femoral fracture, right leg, initial encounter for fracture
ICD-10-CM Codes›M00–M99›M80-M85›M84
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 402
- 7th Character A — Initial Encounter for Fracture
- Not Chronic
M84.754A is a billable ICD-10-CM diagnosis code for complete transverse atypical femoral fracture, right leg, initial encounter for fracture. The 7th character A means initial encounter for fracture, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 521 through 522, 542 through 544, 791, 793. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 214 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Atypical fracture, initial encounter.
For Medicare Advantage risk adjustment, M84.754A maps to CMS-HCC Category 402 (Hip Fracture/Dislocation) under the V28 model, adding a risk factor of about 0.467 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Quality Payment Program MeasuresBilling
Medicare quality measures that can apply when M84.754A is part of the patient record.
Communication with the Physician or Other Clinician Managing On-Going Care Post-Fracture for Men and Women Aged 50 Years and Older
High Priority: YES
Measure Type: Process
Submission Methods: Claims, Registry
Description: Percentage of patients aged 50 years and older treated for a fracture with documentation of communication, between the physician treating the fracture and the physician or other clinician managing the patient’s on-going care, that a fracture occurred and that the patient was or should be considered for osteoporosis treatment or testing. This measure is submitted by the physician who treats the fracture and who therefore is held accountable for the communication.
Osteoporosis Management in Women Who Had a Fracture
High Priority: NO
Measure Type: Process
Submission Methods: Claims, Registry
Description: The percentage of women 50-85 years of age who suffered a fracture and who had either a bone mineral density (BMD) test or prescription for a drug to treat osteoporosis in the 180 days after the fracture.
Medicare Risk Adjustment (HCC)Billing
M84.754A maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to M84.754A: its own notes plus those printed at M84.75, 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)
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 M84.75:
- Ainitial encounter for fracture this code
- Dsubsequent encounter for fracture with routine healing
- 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.
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 M84.754A to ICD-9-CMHistory
Code History & ChangesHistory
Replacement M84.754A replaces the following previously assigned code(s):
- S72.8X1A - Oth fracture of right femur, init encntr for closed fracture
- S72.8X2A - Oth fracture of left femur, init encntr for closed fracture
- S72.8X9A - Oth fracture of unsp femur, init encntr for closed fracture
Questions About M84.754AOverview
Is M84.754A (Complete transverse atypical femoral fracture, right leg) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report complete transverse atypical femoral fracture, right leg, initial encounter for fracture on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character A in M84.754A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for complete transverse atypical femoral fracture, right leg, such as an emergency visit or first evaluation. In this category the CMS Tabular List defines A as "initial encounter for fracture".
What MS-DRG does M84.754A group to?
When complete transverse atypical femoral fracture, right leg, initial encounter for fracture is the principal diagnosis on an inpatient stay, it groups to MS-DRG 543, 793, 791, 521, 544, 522, 542, with relative weights from 0.7404 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.
Is M84.754A a CC or MCC?
CMS lists M84.754A as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 214 closely related codes in its exclusion list.
What is the ICD-9 equivalent of M84.754A?
Under the General Equivalence Mappings, complete transverse atypical femoral fracture, right leg, initial encounter for fracture converts to ICD-9-CM 733.14 (path fx neck of femur) and 733.15 (path fx oth spcf prt fmr). The mapping is approximate, so confirm the match fits the documentation.
What HCC is M84.754A?
M84.754A (complete transverse atypical femoral fracture, right leg, initial encounter for fracture) maps to CMS-HCC Category 402 (Hip Fracture/Dislocation), commonly written as HCC 402, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 170 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.
Does M84.754A risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, M84.754A adds a risk adjustment factor of about 0.467 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.089 to 0.570 depending on the payment segment). HCC 402 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 402 category page.
