M84.4 — Pathological fracture, not elsewhere classified
Is M84.4 billable?
No — M84.4 is a non-billable header code. M84.4 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 60 billable codes beneath M84.4.
Billable codes under this header
- M84.40XAPathological fracture, unspecified site, initial encounter for fracture
- M84.40XDPathological fracture, unspecified site, subsequent encounter for fracture with routine healing
- M84.40XGPathological fracture, unspecified site, subsequent encounter for fracture with delayed healing
- M84.40XKPathological fracture, unspecified site, subsequent encounter for fracture with nonunion
- M84.40XPPathological fracture, unspecified site, subsequent encounter for fracture with malunion
- M84.40XSPathological fracture, unspecified site, sequela
- M84.48XAPathological fracture, other site, initial encounter for fracture
- M84.48XDPathological fracture, other site, subsequent encounter for fracture with routine healing
- M84.48XGPathological fracture, other site, subsequent encounter for fracture with delayed healing
- M84.48XKPathological fracture, other site, subsequent encounter for fracture with nonunion
- M84.48XPPathological fracture, other site, subsequent encounter for fracture with malunion
- M84.48XSPathological fracture, other site, sequela
- M84.411APathological fracture, right shoulder, initial encounter for fracture
- M84.411DPathological fracture, right shoulder, subsequent encounter for fracture with routine healing
- M84.411GPathological fracture, right shoulder, subsequent encounter for fracture with delayed healing
- M84.411KPathological fracture, right shoulder, subsequent encounter for fracture with nonunion
- M84.411PPathological fracture, right shoulder, subsequent encounter for fracture with malunion
- M84.411SPathological fracture, right shoulder, sequela
- M84.412APathological fracture, left shoulder, initial encounter for fracture
- M84.412DPathological fracture, left shoulder, subsequent encounter for fracture with routine healing
- M84.412GPathological fracture, left shoulder, subsequent encounter for fracture with delayed healing
- M84.412KPathological fracture, left shoulder, subsequent encounter for fracture with nonunion
- M84.412PPathological fracture, left shoulder, subsequent encounter for fracture with malunion
- M84.412SPathological fracture, left shoulder, sequela
- M84.419APathological fracture, unspecified shoulder, initial encounter for fracture
- M84.419DPathological fracture, unspecified shoulder, subsequent encounter for fracture with routine healing
- M84.419GPathological fracture, unspecified shoulder, subsequent encounter for fracture with delayed healing
- M84.419KPathological fracture, unspecified shoulder, subsequent encounter for fracture with nonunion
- M84.419PPathological fracture, unspecified shoulder, subsequent encounter for fracture with malunion
- M84.419SPathological fracture, unspecified shoulder, sequela
- M84.421APathological fracture, right humerus, initial encounter for fracture
- M84.421DPathological fracture, right humerus, subsequent encounter for fracture with routine healing
- M84.421GPathological fracture, right humerus, subsequent encounter for fracture with delayed healing
- M84.421KPathological fracture, right humerus, subsequent encounter for fracture with nonunion
- M84.421PPathological fracture, right humerus, subsequent encounter for fracture with malunion
- M84.421SPathological fracture, right humerus, sequela
- M84.422APathological fracture, left humerus, initial encounter for fracture
- M84.422DPathological fracture, left humerus, subsequent encounter for fracture with routine healing
- M84.422GPathological fracture, left humerus, subsequent encounter for fracture with delayed healing
- M84.422KPathological fracture, left humerus, subsequent encounter for fracture with nonunion
- M84.422PPathological fracture, left humerus, subsequent encounter for fracture with malunion
- M84.422SPathological fracture, left humerus, sequela
- M84.429APathological fracture, unspecified humerus, initial encounter for fracture
- M84.429DPathological fracture, unspecified humerus, subsequent encounter for fracture with routine healing
- M84.429GPathological fracture, unspecified humerus, subsequent encounter for fracture with delayed healing
- M84.429KPathological fracture, unspecified humerus, subsequent encounter for fracture with nonunion
- M84.429PPathological fracture, unspecified humerus, subsequent encounter for fracture with malunion
- M84.429SPathological fracture, unspecified humerus, sequela
- M84.431APathological fracture, right ulna, initial encounter for fracture
- M84.431DPathological fracture, right ulna, subsequent encounter for fracture with routine healing
- M84.431GPathological fracture, right ulna, subsequent encounter for fracture with delayed healing
- M84.431KPathological fracture, right ulna, subsequent encounter for fracture with nonunion
- M84.431PPathological fracture, right ulna, subsequent encounter for fracture with malunion
- M84.431SPathological fracture, right ulna, sequela
- M84.432APathological fracture, left ulna, initial encounter for fracture
- M84.432DPathological fracture, left ulna, subsequent encounter for fracture with routine healing
- M84.432GPathological fracture, left ulna, subsequent encounter for fracture with delayed healing
- M84.432KPathological fracture, left ulna, subsequent encounter for fracture with nonunion
- M84.432PPathological fracture, left ulna, subsequent encounter for fracture with malunion
- M84.432SPathological fracture, left ulna, sequela
M84.4 at a glance
| Code | M84.4 |
|---|---|
| Description | Pathological fracture, not elsewhere classified |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Excludes1 — never code together
The conditions below can never be reported together with M84.4 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Excludes2 — not included here
The conditions below are not part of M84.4, but a patient may have both at the same time. When documentation supports it, M84.4 and the excluded code may both be reported.
- personal history of (healed) pathological fracture (Z87.311)
Inclusion terms
Alternative wording in documentation that is classified to M84.4.
- Chronic fracture
- Pathological fracture NOS
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M84.4, but a patient may have both at the same time. When documentation supports it, M84.4 and the excluded code may both be reported.
- 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)
Excludes2 — not included here — inherited from M84
The conditions below are not part of M84.4, but a patient may have both at the same time. When documentation supports it, M84.4 and the excluded code may both be reported.
- traumatic fracture of bone-see fracture, by site
What codes fall under M84.4? (9)
- M84.40Pathological fracture, unspecified sitenot billable
- M84.41Pathological fracture, shouldernot billable
- M84.42Pathological fracture, humerusnot billable
- M84.43Pathological fracture, ulna and radiusnot billable
- M84.44Pathological fracture, hand and fingersnot billable
- M84.45Pathological fracture, femur and pelvisnot billable
- M84.46Pathological fracture, tibia and fibulanot billable
- M84.47Pathological fracture, ankle, foot and toesnot billable
- M84.48Pathological fracture, other sitenot billable
How long has M84.4 existed?
M84.4 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
What other codes are in the M84 family? (6)
- M84.3Stress fracturenot billable
- M84.5Pathological fracture in neoplastic diseasenot billable
- M84.6Pathological fracture in other diseasenot billable
- M84.7Nontraumatic fracture, not elsewhere classifiednot billable
- M84.8Other disorders of continuity of bonenot billable
- M84.9Disorder of continuity of bone, unspecified