M84.41 — Pathological fracture, shoulder
Is M84.41 billable?
No — M84.41 is a non-billable header code. M84.41 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 18 billable codes beneath M84.41.
Billable codes under this header
- 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
M84.41 at a glance
| Code | M84.41 |
|---|---|
| Description | Pathological fracture, shoulder |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
How is M84.41 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to M84.41. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Fracture, pathological › clavicle (pathologic)
- Fracture, pathological › scapula (pathologic)
Excludes1 — never code together — inherited from M84.4
The conditions below can never be reported together with M84.41 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 M84.41, but a patient may have both at the same time. When documentation supports it, M84.41 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 M84.41, but a patient may have both at the same time. When documentation supports it, M84.41 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 M84.41, but a patient may have both at the same time. When documentation supports it, M84.41 and the excluded code may both be reported.
- personal history of (healed) pathological fracture (Z87.311)
What codes fall under M84.41? (3)
How long has M84.41 existed?
M84.41 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)
- M84.40Pathological fracture, unspecified sitenot 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