ICDcodes.org
FY2027

M84.42 — Pathological fracture, humerus

Not billable

Is M84.42 billable?

No — M84.42 is a non-billable header code. M84.42 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 M84.42.

Billable codes under this header

M84.42 at a glance

CodeM84.42
DescriptionPathological fracture, humerus
BillableNo — header code
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

How is M84.42 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to M84.42. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Fracture, pathological › humerus (pathologic)

Excludes1 — never code together — inherited from M84.4

The conditions below can never be reported together with M84.42 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 M84.42, but a patient may have both at the same time. When documentation supports it, M84.42 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 M84.42, but a patient may have both at the same time. When documentation supports it, M84.42 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 M84.42, but a patient may have both at the same time. When documentation supports it, M84.42 and the excluded code may both be reported.

  • personal history of (healed) pathological fracture (Z87.311)

What codes fall under M84.42? (3)

How long has M84.42 existed?

M84.42 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)