M84.6
Header — not billablePathological fracture in other disease
The ICD-10 code for pathological fracture in other disease is M84.6.
M84.6 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
Code also
Two codes may be needed to fully describe a condition, but unlike Code First/Use Additional Code, the sequencing order is not mandated by convention.
- underlying condition
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).
- pathological fracture in osteoporosis (M80.-)
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 M84.6:
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 M84.6
- M84.60Pathological fracture in other disease, unspecified site
- M84.61Pathological fracture in other disease, shouldernon-billable header
- M84.62Pathological fracture in other disease, humerusnon-billable header
- M84.63Pathological fracture in other disease, ulna and radiusnon-billable header
- M84.64Pathological fracture in other disease, handnon-billable header
- M84.65Pathological fracture in other disease, pelvis and femurnon-billable header
- M84.66Pathological fracture in other disease, tibia and fibulanon-billable header
- M84.67Pathological fracture in other disease, ankle and footnon-billable header
- M84.68Pathological fracture in other disease, other site
Related codes in this category
- M84.3Stress fracturenon-billable header
- M84.4Pathological fracture, not elsewhere classifiednon-billable header
- M84.5Pathological fracture in neoplastic 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
- M84.6Pathological fracture in other diseasenon-billable header