M84.759A — Complete oblique atypical femoral fracture, unspecified leg, initial encounter for fracture
Is M84.759A billable?
Yes, but M84.759A will trip a Medicare edit. M84.759A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists M84.759A under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.
More specific alternatives
- M84.751AIncomplete atypical femoral fracture, right leg, initial encounter for fracture
- M84.752AIncomplete atypical femoral fracture, left leg, initial encounter for fracture
- M84.754AComplete transverse atypical femoral fracture, right leg, initial encounter for fracture
- M84.755AComplete transverse atypical femoral fracture, left leg, initial encounter for fracture
- M84.757AComplete oblique atypical femoral fracture, right leg, initial encounter for fracture
- M84.758AComplete oblique atypical femoral fracture, left leg, initial encounter for fracture
M84.759A at a glance
| Code | M84.759A |
|---|---|
| Description | Complete oblique atypical femoral fracture, unspecified leg, 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 M84.759A?
In M84.759A, the 7th character A means initial encounter for fracture. The 7th character is required for M84.759A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to M84.759A?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name M84.759A directly.
A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.
Which MS-DRGs does M84.759A group to?
M84.759A sits in MDC 08 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 521Hip Replacement with Principal Diagnosis of Hip Fracture with MCCsurgical
- 522Hip Replacement with Principal Diagnosis of Hip Fracture without MCCsurgical
As a secondary diagnosis, M84.759A is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is M84.759A listed in the Alphabetic Index?
The Alphabetic Index lists these routes under M84.759, the nearest indexed parent of M84.759A. Use them to find the family, then select the specific code.
- Fracture, nontraumatic, NEC › atypical › femur › complete › oblique
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M84.759A, but a patient may have both at the same time. When documentation supports it, M84.759A 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 M84.759A, but a patient may have both at the same time. When documentation supports it, M84.759A and the excluded code may both be reported.
- traumatic fracture of bone-see fracture, by site
How long has M84.759A existed?
M84.759A first appears in FY2018 (FY2017 is not available, so it may have appeared then).
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.