M84.478 — Pathological fracture, left toe(s)
Is M84.478 billable?
No — M84.478 is a non-billable header code. M84.478 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 M84.478.
Billable codes under this header
- M84.478APathological fracture, left toe(s), initial encounter for fracture
- M84.478DPathological fracture, left toe(s), subsequent encounter for fracture with routine healing
- M84.478GPathological fracture, left toe(s), subsequent encounter for fracture with delayed healing
- M84.478KPathological fracture, left toe(s), subsequent encounter for fracture with nonunion
- M84.478PPathological fracture, left toe(s), subsequent encounter for fracture with malunion
- M84.478SPathological fracture, left toe(s), sequela
M84.478 at a glance
| Code | M84.478 |
|---|---|
| Description | Pathological fracture, left toe(s) |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
How is M84.478 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under M84.47, the nearest indexed parent of M84.478. Use them to find the family, then select the specific code.
- Fracture, pathological › ankle (pathologic)
- Fracture, pathological › metatarsus (pathologic)
- Fracture, pathological › tarsus (pathologic)
- Fracture, pathological › toe (pathologic)
Excludes1 — never code together — inherited from M84.4
The conditions below can never be reported together with M84.478 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 M84.478, but a patient may have both at the same time. When documentation supports it, M84.478 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 M84.478, but a patient may have both at the same time. When documentation supports it, M84.478 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 M84.478, but a patient may have both at the same time. When documentation supports it, M84.478 and the excluded code may both be reported.
- personal history of (healed) pathological fracture (Z87.311)
What codes fall under M84.478? (6)
- M84.478APathological fracture, left toe(s), initial encounter for fracture
- M84.478DPathological fracture, left toe(s), subsequent encounter for fracture with routine healing
- M84.478GPathological fracture, left toe(s), subsequent encounter for fracture with delayed healing
- M84.478KPathological fracture, left toe(s), subsequent encounter for fracture with nonunion
- M84.478PPathological fracture, left toe(s), subsequent encounter for fracture with malunion
- M84.478SPathological fracture, left toe(s), sequela
How long has M84.478 existed?
M84.478 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 M84.47 family? (8)
- M84.471Pathological fracture, right anklenot billable
- M84.472Pathological fracture, left anklenot billable
- M84.473Pathological fracture, unspecified anklenot billable
- M84.474Pathological fracture, right footnot billable
- M84.475Pathological fracture, left footnot billable
- M84.476Pathological fracture, unspecified footnot billable
- M84.477Pathological fracture, right toe(s)not billable
- M84.479Pathological fracture, unspecified toe(s)not billable