M84.5

Header — not billable

Pathological fracture in neoplastic disease

The ICD-10 code for pathological fracture in neoplastic disease is M84.5.

M84.5 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 neoplasm

7th character definitions

These definitions specify what each valid 7th-character value means for codes in this category.

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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 M84.5:

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.
•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 M84.5

Related codes in this category

M84.3Stress fracturenon-billable header
M84.4Pathological fracture, not elsewhere classifiednon-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
M84.5Pathological fracture in neoplastic diseasenon-billable header