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M84.461Non-billableSave

M84.461 - Pathological fracture, right tibia

ICD-10-CM Chapter 13: Diseases of the musculoskeletal system and connective tissue · M80-M85 Disorders of bone density and structure (M80-M85) · Subcategory of M84.46 · FY2027

Coding Guidance

M84.461 requires a 7th character. Report the code below that matches the documentation, for example A for initial encounter for fracture, D for subsequent encounter for fracture with routine healing, G for subsequent encounter for fracture with delayed healing.

7th Character

The appropriate 7th character is to be added to each code from subcategory M84.4:

Includes, Excludes and Coding Notes

Excludes 1 — Not Coded HereFrom M84.4

Mutually exclusive: these conditions are never reported together with this code.

  • 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.-)
Excludes 2 — Not Included HereFrom M84.4

Not part of this code; report both codes when the patient has both conditions.

  • personal history of (healed) pathological fracture (Z87.311)
Excludes 2 — Not Included HereFrom M84

Not part of this code; report both codes when the patient has both conditions.

  • traumatic fracture of bone-see fracture, by site
Excludes 2 — Not Included HereFrom Chapter M00-M99

Not part of this code; report both codes when the patient has both conditions.

  • 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)
NotesFrom Chapter M00-M99

Instructional notes from the ICD-10-CM tabular list.

  • Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition

More Specific Codes (6)

M84.461APathological fracture, right tibia, initial encounter for fracture→M84.461DPathological fracture, right tibia, subsequent encounter for fracture with routine healing→M84.461GPathological fracture, right tibia, subsequent encounter for fracture with delayed healing→M84.461KPathological fracture, right tibia, subsequent encounter for fracture with nonunion→M84.461PPathological fracture, right tibia, subsequent encounter for fracture with malunion→M84.461SPathological fracture, right tibia, sequela→

Related condition guides

Documentation requirements, coding pitfalls and FAQs for conditions coded with M84.461.