{"code":"M84.464A","type":"code","title":"Pathological fracture, left fibula, initial encounter for fracture","codeAlso":[],"includes":[],"modern_v":"official26","codeFirst":[],"excludes1":["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.-)"],"excludes2":["personal history of (healed) pathological fracture (Z87.311)","traumatic fracture of bone-see fracture, by site"],"isBillable":true,"fyEffectivity":{"fy2026":true,"fy2027":true,"billableFy2026":true,"billableFy2027":true},"sibling_codes":["M84","M84.3","M84.30","M84.30XA","M84.30XD","M84.30XG","M84.30XK","M84.30XP","M84.30XS","M84.31","M84.311","M84.311A","M84.311D","M84.311G","M84.311K","M84.311P","M84.311S","M84.312","M84.312A","M84.312D","M84.312G","M84.312K","M84.312P","M84.312S","M84.319","M84.319A","M84.319D","M84.319G","M84.319K","M84.319P","M84.319S","M84.32","M84.321","M84.321A","M84.321D","M84.321G","M84.321K","M84.321P","M84.321S","M84.322","M84.322A","M84.322D","M84.322G","M84.322K","M84.322P","M84.322S","M84.329","M84.329A","M84.329D","M84.329G","M84.329K","M84.329P","M84.329S","M84.33","M84.331","M84.331A","M84.331D","M84.331G","M84.331K","M84.331P","M84.331S","M84.332","M84.332A","M84.332D","M84.332G","M84.332K","M84.332P","M84.332S","M84.333","M84.333A","M84.333D","M84.333G","M84.333K","M84.333P","M84.333S","M84.334","M84.334A","M84.334D","M84.334G","M84.334K","M84.334P","M84.334S","M84.339","M84.339A","M84.339D","M84.339G","M84.339K","M84.339P","M84.339S","M84.34","M84.341","M84.341A","M84.341D","M84.341G","M84.341K","M84.341P","M84.341S","M84.342","M84.342A","M84.342D"],"inclusionTerms":[],"sibling_titles":{"code":"M84.342D","title":"Stress fracture, left hand, subsequent encounter for fracture with routine healing","isBillable":true},"useAdditionalCode":[],"clinicalDefinition":"Pathological fracture, left fibula, initial encounter for fracture is a billable ICD-10-CM diagnosis code (M84.464A). Excludes1 (not coded here): 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.-).","officialDefinition":"Pathological fracture, left fibula, initial encounter for fracture is a billable ICD-10-CM diagnosis code (M84.464A). Excludes1 (not coded here): 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.-). Excludes2 (not included here): personal history of (healed) pathological fracture (Z87.311); traumatic fracture of bone-see fracture, by site. 7th character: The appropriate 7th character is to be added to each code from subcategory M84.4:.","seventhCharacterInstructions":["The appropriate 7th character is to be added to each code from subcategory M84.4:"],"workflowProtocols":[],"guidelines":{"whenToUse":[],"whenNotToUse":[],"commonBillingMistakes":[],"codeComparisons":[],"documentationChecklist":[]},"domainLandscape":{"summary":"Primary diagnostic domain and clinical landscape evaluation.","keyCategories":[],"diagnosticContinuum":"Progression continuum from acute presentation to resolution."},"children":[],"hierarchy":[],"relatedCodes":[],"relevantCPTCodes":[],"documentationTips":[],"caseStudies":[],"description":"","overview":"","noteProvenance":{"traumatic fracture of bone-see fracture, by site":"M84","collapsed vertebra NEC (M48.5)":"M84.4","pathological fracture in neoplastic disease (M84.5-)":"M84.4","pathological fracture in osteoporosis (M80.-)":"M84.4","pathological fracture in other disease (M84.6-)":"M84.4","stress fracture (M84.3-)":"M84.4","traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)":"M84.4","personal history of (healed) pathological fracture (Z87.311)":"M84.4","Chronic fracture":"M84.4","Pathological fracture NOS":"M84.4"},"hcc":{"mapped":false,"model":"CMS-HCC V28","paymentYear":"2026","categories":[],"otherModels":[{"model":"RxHCC V08","hcc":"87"}]}}