M84.40XD — Pathological fracture, unspecified site, subsequent encounter for fracture with routine healing
Is M84.40XD billable?
Yes, but M84.40XD is an unspecified code. M84.40XD is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, M84.40XD is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting M84.40XD — the more specific alternatives are listed below.
More specific alternatives
- M84.30XDStress fracture, unspecified site, subsequent encounter for fracture with routine healing
- M84.50XDPathological fracture in neoplastic disease, unspecified site, subsequent encounter for fracture with routine healing
- M84.60XDPathological fracture in other disease, unspecified site, subsequent encounter for fracture with routine healing
M84.40XD at a glance
| Code | M84.40XD |
|---|---|
| Description | Pathological fracture, unspecified site, subsequent encounter for fracture with routine healing |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "D" | subsequent encounter for fracture with routine healing |
What does the 7th character "D" mean in M84.40XD?
In M84.40XD, the 7th character D means subsequent encounter for fracture with routine healing. The 7th character is required for M84.40XD to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does M84.40XD group to?
M84.40XD sits in MDC 08 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 559Aftercare, Musculoskeletal System and Connective Tissue with MCCmedical
- 560Aftercare, Musculoskeletal System and Connective Tissue with CCmedical
- 561Aftercare, Musculoskeletal System and Connective Tissue without CC/MCCmedical
Excludes1 — never code together — inherited from M84.4
The conditions below can never be reported together with M84.40XD 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 M84.40XD, but a patient may have both at the same time. When documentation supports it, M84.40XD 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 M84.40XD, but a patient may have both at the same time. When documentation supports it, M84.40XD 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 M84.40XD, but a patient may have both at the same time. When documentation supports it, M84.40XD and the excluded code may both be reported.
- personal history of (healed) pathological fracture (Z87.311)
How long has M84.40XD existed?
M84.40XD 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.