M84.40XP vs M84.6
M84.40XP (Pathological fracture, unspecified site, subsequent encounter for fracture with malunion) 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. M84.40XP 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
| M84.40XPPathological fracture, unspecified site, subsequent encounter for fracture with malunion | M84.6Pathological fracture in other disease | |
|---|---|---|
| Billing status | Billable | 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, unspecified site, subsequent encounter for fracture with malunion is a billable ICD-10-CM diagnosis code (M84.40P). | 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: |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources