Enhanced MS-DRG Definitions Manual

ICD-10-CM Diagnosis code M84.4

Pathological fracture, not elsewhere classified

Code Hierarchy

Coding Guidelines for M84.4

M84.4 is a valid ICD-10-CM diagnosis code meaning 'Pathological fracture, not elsewhere classified'.

It is also suitable for:

  • Chronic fracture
  • Pathological fracture NOS

Purely Excluded Conditions

These diag codes should never be used at the same time as M84.4 because these conditions cannot occur together:

  • collapsed vertebra NEC (M48.5)
  • pathological fracture in neoplastic disease (M84.5-)
  • pathological fracture in osteoporosis (M80.-)
  • pathological fracture in other disease (M84.6-)
  • stress fracture (M84.3-)
  • traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)

Separate Conditions Not Covered By M84.4

These conditions are is not covered by M84.4:

  • personal history of (healed) pathological fracture (Z87.311)

A patient may have both conditions at the same time, but both conditions must be coded separately.

Complications & Comorbid Conditions (CC/MCC) Rules for M84.4

M84.4 is not a CC or MCC.

DRG Mapping Rules for M84.4

M84.4 doesn't map to any MS-DRGs.

About the Turquoise Health MS-DRG Manual Browser

We build tools and machine learning systems that simplify healthcare revenue cycle operations. We were frustrated with the formatting of the MS-DRG rules, so we built our own solution.

MS-DRG rules and ICD-10 CM/PCS codes are automatically parsed from CMS's MS-DRG data files. All content is provided strictly “AS IS” and may contain parsing errors. If you spot an error, please let us know.

We have converted the MS-DRG logic into fully structured, machine-readable data. If you need structured data versions of the MS-DRG manuals, we would love to talk with you.

Quick Links

2020 © Turquoise Health

Quick Actions

Orders
Uploades
Products
Customers
Blog Posts
Settings