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M84.561A vs M84.562A

M84.561A (Pathological fracture in neoplastic disease, right tibia, initial encounter for fracture) compared with M84.562A (Pathological fracture in neoplastic disease, left tibia, initial encounter for fracture), from the official CMS tabular data. M84.561A and M84.562A code the same condition on opposite sides.

Relationship

Review

Laterality relationship

M84.561A
Right
Pathological fracture in neoplastic disease, right tibia, initial encounter for fracture
M84.562A
Left
Pathological fracture in neoplastic disease, left tibia, initial encounter for fracture

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)

Can these codes be reported together?

Same condition, opposite side. M84.561A and M84.562A 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.

Side by side

M84.561APathological fracture in neoplastic disease, right tibia, initial encounter for fractureM84.562APathological fracture in neoplastic disease, left tibia, initial encounter for fracture
Billing statusBillableBillable
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 in neoplastic disease, right tibia, initial encounter for fracture is a billable ICD-10-CM diagnosis code (M84.561A).Pathological fracture in neoplastic disease, left tibia, initial encounter for fracture is a billable ICD-10-CM diagnosis code (M84.562A).
7th characterThe appropriate 7th character is to be added to each code from subcategory M84.5:The appropriate 7th character is to be added to each code from subcategory M84.5:

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