Skip to main content

M84.48XK vs M84.5

M84.48XK (Pathological fracture, other site, subsequent encounter for fracture with nonunion) compared with M84.5 (Pathological fracture in neoplastic disease), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Relationship

Conflict

Excludes1 conflict

M84.48XK
Pathological fracture, other site, subsequent encounter for fracture with nonunion
↔
M84.5
Pathological fracture in neoplastic disease

Not coded here — these two are mutually exclusive.

“pathological fracture in neoplastic disease (M84.5-)”

An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as unrelated to each other.

Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Can these codes be reported together?

No — do not report together. M84.48XK carries an Excludes1 note covering M84.5: “pathological fracture in neoplastic disease (M84.5-)”

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

M84.48XKPathological fracture, other site, subsequent encounter for fracture with nonunionM84.5Pathological fracture in neoplastic disease
Billing statusBillableNon-billable header
ClassificationM00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
DefinitionPathological fracture, other site, subsequent encounter for fracture with nonunion is a billable ICD-10-CM diagnosis code (M84.48K).Pathological fracture in neoplastic disease is a non-billable ICD-10-CM category code (M84.5).
7th characterThe 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 M84.5:
Edit this comparisonCheck a whole claim

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources