M84.40XG — Pathological fracture, unspecified site, subsequent encounter for fracture with delayed healing
Is M84.40XG billable?
Yes, but M84.40XG is an unspecified code. M84.40XG is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, M84.40XG 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 M84.40XG — the more specific alternatives are listed below.
More specific alternatives
- M84.30XGStress fracture, unspecified site, subsequent encounter for fracture with delayed healing
- M84.50XGPathological fracture in neoplastic disease, unspecified site, subsequent encounter for fracture with delayed healing
- M84.60XGPathological fracture in other disease, unspecified site, subsequent encounter for fracture with delayed healing
M84.40XG at a glance
| Code | M84.40XG |
|---|---|
| Description | Pathological fracture, unspecified site, subsequent encounter for fracture with delayed healing |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "G" | subsequent encounter for fracture with delayed healing |
What does the 7th character "G" mean in M84.40XG?
In M84.40XG, the 7th character G means subsequent encounter for fracture with delayed healing. The 7th character is required for M84.40XG to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does M84.40XG group to?
M84.40XG 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 M84.40XG 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 M84.40XG, but a patient may have both at the same time. When documentation supports it, M84.40XG 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 M84.40XG, but a patient may have both at the same time. When documentation supports it, M84.40XG 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 M84.40XG, but a patient may have both at the same time. When documentation supports it, M84.40XG and the excluded code may both be reported.
- personal history of (healed) pathological fracture (Z87.311)
How long has M84.40XG existed?
M84.40XG 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.