M84.3 vs M84.48XP
M84.3 (Stress fracture) compared with M84.48XP (Pathological fracture, other site, subsequent encounter for fracture with malunion), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. M84.3 carries an Excludes1 note covering M84.48XP: “pathological fracture NOS (M84.4.-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
No — do not report together. M84.48XP carries an Excludes1 note covering M84.3: “stress fracture (M84.3-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| M84.3Stress fracture | M84.48XPPathological fracture, other site, subsequent encounter for fracture with malunion | |
|---|---|---|
| Billing status | Non-billable header Report instead: M84.30XA, M84.30XD, M84.30XG, M84.30XK, M84.30XP | Billable |
| Classification | M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) | M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) |
| Definition | Stress fracture is a non-billable ICD-10-CM category code (M84.3). | Pathological fracture, other site, subsequent encounter for fracture with malunion is a billable ICD-10-CM diagnosis code (M84.48P). |
| 7th character | The appropriate 7th character is to be added to each code from subcategory M84.3: | The appropriate 7th character is to be added to each code from subcategory M84.4: |
| Includes | Fatigue fracture March fracture Stress fracture NOS Stress reaction | — |
| Use additional code | external cause code(s) to identify the cause of the stress fracture | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources