M84.4 vs M84.6
M84.4 (Pathological fracture, not elsewhere classified) compared with M84.6 (Pathological fracture in other disease), 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. M84.4 carries an Excludes1 note covering M84.6: “pathological fracture in other disease (M84.6-)”
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
| M84.4Pathological fracture, not elsewhere classified | M84.6Pathological fracture in other disease | |
|---|---|---|
| Billing status | Non-billable header Report instead: M84.40XA, M84.40XD, M84.40XG, M84.40XK, M84.40XP | Non-billable header Report instead: M84.60XA, M84.60XD, M84.60XG, M84.60XK, M84.60XP |
| 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 | Pathological fracture, not elsewhere classified is a non-billable ICD-10-CM category code (M84.4). | Pathological fracture in other disease is a non-billable ICD-10-CM category code (M84.6). |
| 7th character | The appropriate 7th character is to be added to each code from subcategory M84.4: | The appropriate 7th character is to be added to each code from subcategory M84.6: |
| Includes | Chronic fracture Pathological fracture NOS | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources