M84.4
Header — not billablePathological fracture, not elsewhere classified
The ICD-10 code for pathological fracture, not elsewhere classified is M84.4.
M84.4 is a non-billable header code. It groups related conditions but cannot be used on its own for reimbursement — select one of the 9 more specific codes below.
Clinical notes
Excludes1 (not coded here)
An Excludes1 note is a pure exclusion: the excluded condition and this code should never be reported together, because the two conditions cannot occur at the same time (e.g. a congenital form vs. an acquired form of the same disease).
Excludes2 (not included here)
An Excludes2 note means the excluded condition is not part of this one, but a patient can have both at the same time — in that case both codes may be reported together.
- personal history of (healed) pathological fracture (Z87.311)
Also known as
Alternate wording, synonyms, or specific conditions that fall under this code, listed to help confirm you've picked the right one.
- Chronic fracture
- Pathological fracture NOS
7th character definitions
These definitions specify what each valid 7th-character value means for codes in this category.
- [object Object]
7th character note
This category requires a 7th character to indicate additional clinical detail (e.g. encounter type: initial, subsequent, sequela). The code is incomplete without it.
- The appropriate 7th character is to be added to each code from subcategory M84.4:
Documentation support
General coding-documentation guidance — not a substitute for payer-specific requirements or professional coding judgment.
- •This is a non-billable header code. Documentation must support a more specific child code before this diagnosis can be reported on a claim.
- •Confirm the excluded condition(s) listed above are not also present — Excludes1 conditions cannot be coded together with this one.
- •This category requires a 7th character. Documentation should clearly indicate the episode of care (initial encounter, subsequent encounter, or sequela).
- •As a general rule, code to the highest level of specificity supported by the documentation in the medical record.
Child codes under M84.4
- M84.40Pathological fracture, unspecified site
- M84.41Pathological fracture, shouldernon-billable header
- M84.42Pathological fracture, humerusnon-billable header
- M84.43Pathological fracture, ulna and radiusnon-billable header
- M84.44Pathological fracture, hand and fingersnon-billable header
- M84.45Pathological fracture, femur and pelvisnon-billable header
- M84.46Pathological fracture, tibia and fibulanon-billable header
- M84.47Pathological fracture, ankle, foot and toesnon-billable header
- M84.48Pathological fracture, other site
Related codes in this category
- M84.3Stress fracturenon-billable header
- M84.5Pathological fracture in neoplastic diseasenon-billable header
- M84.6Pathological fracture in other diseasenon-billable header
- M84.7Nontraumatic fracture, not elsewhere classifiednon-billable header
- M84.8Other disorders of continuity of bonenon-billable header
- M84.9Disorder of continuity of bone, unspecified
- M84.4Pathological fracture, not elsewhere classifiednon-billable header