M84.58XA — Pathological fracture in neoplastic disease, other specified site, initial encounter for fracture
Is M84.58XA billable?
Yes, but M84.58XA is an unspecified code. M84.58XA is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, M84.58XA 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 M84.58XA — the more specific alternatives are listed below.
More specific alternatives
- M84.511APathological fracture in neoplastic disease, right shoulder, initial encounter for fracture
- M84.521APathological fracture in neoplastic disease, right humerus, initial encounter for fracture
- M84.531APathological fracture in neoplastic disease, right ulna, initial encounter for fracture
- M84.541APathological fracture in neoplastic disease, right hand, initial encounter for fracture
- M84.550APathological fracture in neoplastic disease, pelvis, initial encounter for fracture
- M84.561APathological fracture in neoplastic disease, right tibia, initial encounter for fracture
- M84.571APathological fracture in neoplastic disease, right ankle, initial encounter for fracture
M84.58XA at a glance
| Code | M84.58XA |
|---|---|
| Description | Pathological fracture in neoplastic disease, other specified site, initial encounter for fracture |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter for fracture |
What does the 7th character "A" mean in M84.58XA?
In M84.58XA, the 7th character A means initial encounter for fracture. The 7th character is required for M84.58XA to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does M84.58XA group to?
M84.58XA 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.
- 456Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, or Infection with MCCsurgical
- 457Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, or Infection with CCsurgical
- 458Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, or Infection without CC/MCCsurgical
As a secondary diagnosis, M84.58XA is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is M84.58XA listed in the Alphabetic Index?
The Alphabetic Index lists these routes under M84.58, the nearest indexed parent of M84.58XA. Use them to find the family, then select the specific code.
- Collapse › vertebra › in › neoplasm
- Fracture, pathological › due to › neoplastic disease NEC › neck (pathologic)
- Fracture, pathological › due to › neoplastic disease NEC › rib (pathologic)
- Fracture, pathological › due to › neoplastic disease NEC › skull (pathologic)
- Fracture, pathological › due to › neoplastic disease NEC › specified site NEC (pathologic)
- Fracture, pathological › due to › neoplastic disease NEC › vertebra (pathologic)
Inclusion terms
Alternative wording in documentation that is classified to M84.58XA.
- Pathological fracture in neoplastic disease, vertebrae
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M84.58XA, but a patient may have both at the same time. When documentation supports it, M84.58XA 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 M84.58XA, but a patient may have both at the same time. When documentation supports it, M84.58XA and the excluded code may both be reported.
- traumatic fracture of bone-see fracture, by site
Code also — inherited from M84.5
Two codes may be needed to describe the condition fully. Whether M84.58XA is sequenced first depends on the reason for the encounter.
- underlying neoplasm
How long has M84.58XA existed?
M84.58XA 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.