M84.421A (Pathological fracture, right humerus, initial encounter for fracture) compared with M84.422A (Pathological fracture, left humerus, initial encounter for fracture), from the official CMS tabular data. M84.421A and M84.422A code the same condition on opposite sides.
Same condition; these differ only in which side is documented.
These codes share a category and title and differ only in the side affected. The documentation decides which applies, and a bilateral code is reported only where the code set provides one.
Source: ICD-10-CM tabular list (laterality variant derived from the code title)
Same condition, opposite side. M84.421A and M84.422A name the same condition on opposite sides of the body.
Same category and title, differing only in which side is affected — the documentation decides which one applies, and a bilateral code is reported only where the code set provides one.
| M84.421APathological fracture, right humerus, initial encounter for fracture | M84.422APathological fracture, left humerus, initial encounter for fracture | |
|---|---|---|
| Billing status | Billable | 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 | Pathological fracture, right humerus, initial encounter for fracture is a billable ICD-10-CM diagnosis code (M84.421A). | Pathological fracture, left humerus, initial encounter for fracture is a billable ICD-10-CM diagnosis code (M84.422A). |
| 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 M84.4: |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources