M84.40XD vs Z87.311

M84.40XD (Pathological fracture, unspecified site, subsequent encounter for fracture with routine healing) compared with Z87.311 (Personal history of (healed) other pathological fracture), from the official CMS tabular data.

Summary

These codes can be reported together when both conditions are documented, because M84.40XD lists Z87.311 under Excludes2, which marks them as distinct conditions.

Official rule

What is different?

The conditions named and chapter.M84.40XD is “Pathological fracture, unspecified site, subsequent encounter for fracture with routine healing”; Z87.311 is “Personal history of (healed) other pathological fracture”. M84.40XD sits in M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99); Z87.311 in Z00-Z99 — Factors Influencing Health Status and Contact with Health Services (Z00-Z99).

Registry fact

Can these codes be reported together?

Yes, when both are documented.M84.40XD lists Z87.311 under Excludes2: “personal history of (healed) pathological fracture (Z87.311)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. M84.40XD carries 6 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.M84.40XD’s tabular entry: “personal history of (healed) pathological fracture (Z87.311)”. The note covers Z87.311.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

No.Both are billable codes, and neither contains the other.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

M84.40XD

Pathological fracture, unspecified site, subsequent encounter for fracture with routine healing

↔

Z87.311

Personal history of (healed) other pathological fracture

What we found

Yes, when both are documented.M84.40XD carries an Excludes2 note covering Z87.311: “personal history of (healed) pathological fracture (Z87.311)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2 Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

Section I.A.12.b — Excludes2 · applies to: Excludes2
A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

	M84.40XDPathological fracture, unspecified site, subsequent encounter for fracture with routine healing	Z87.311Personal history of (healed) other pathological fracture
Billing status	Billable	Billable
Classification	M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)	Z00-Z99 — Factors Influencing Health Status and Contact with Health Services (Z00-Z99)
Definition	Pathological fracture, unspecified site, subsequent encounter for fracture with routine healing is a billable ICD-10-CM diagnosis code (M84.40XD).	Personal history of (healed) other pathological fracture is a billable ICD-10-CM diagnosis code (Z87.311).
7th character	The appropriate 7th character is to be added to each code from subcategory M84.4:	—
Includes	—	Personal history of (healed) collapsed vertebra NOS
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	personal history of osteoporosis fracture (Z87.310) personal history of (healed) traumatic fracture (Z87.81)
Code first	—	any follow-up examination after treatment (Z09)
Code also	—	any follow-up examination (Z08-Z09)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources