M84.40 — Pathological fracture, unspecified site
Is M84.40 billable?
No — M84.40 is a non-billable header code. M84.40 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 6 billable codes beneath M84.40.
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
M84.40 at a glance
| Code | M84.40 |
|---|---|
| Description | Pathological fracture, unspecified site |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Excludes1 — never code together — inherited from M84.4
The conditions below can never be reported together with M84.40 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 — inherited from Chapter 13
The conditions below are not part of M84.40, but a patient may have both at the same time. When documentation supports it, M84.40 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 M84.40, but a patient may have both at the same time. When documentation supports it, M84.40 and the excluded code may both be reported.
- traumatic fracture of bone-see fracture, by site
Excludes2 — not included here — inherited from M84.4
The conditions below are not part of M84.40, but a patient may have both at the same time. When documentation supports it, M84.40 and the excluded code may both be reported.
- personal history of (healed) pathological fracture (Z87.311)
What codes fall under M84.40? (6)
- 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
How long has M84.40 existed?
M84.40 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 M84.4 family? (8)
- 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