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M84.374A ICD-10-CM Code: Stress fracture, right foot, initial encounter for fracture

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

7th character
Required — see the character table on this page
Tabular directives
3 Excludes1 · 3 Excludes2 · 1 use-additional code

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 542 — PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC (MDC 08)
  • MS-DRG 543 — PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC (MDC 08)
  • MS-DRG 544 — PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC (MDC 08)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Code Overview

Stress fracture, right foot, initial encounter for fracture is a billable ICD-10-CM diagnosis code (M84.374A).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for M84.374A in the official ICD-10-CM tabular list.

Notes without a marker are published on M84.374A itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from M84.3

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • external cause code(s) to identify the cause of the stress fracture

Source: inherited from M84.3

7th Character Guide

"The appropriate 7th character is to be added to each code from subcategory M84.3:"

  • A — initial encounter for fracture (this page’s code)
  • D — subsequent encounter for fracture with routine healing
  • G — subsequent encounter for fracture with delayed healing
  • K — subsequent encounter for fracture with nonunion
  • P — subsequent encounter for fracture with malunion
  • S — sequela

How the encounter character is assigned. “Initial encounter” means the patient is receiving active treatment for the condition — it is not limited to the first visit, and a different or new provider giving active treatment still assigns it. “Subsequent encounter” covers care during the healing or recovery phase after active treatment. “Sequela” is for complications or conditions that arise as a direct result of the original condition.

ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.19.a (paraphrased by MedCoder).

Variant codes in this family

M84.374A, M84.374D, M84.374G, M84.374K, M84.374P, M84.374S

Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Stress fracture, right foot, initial encounter for fracture

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. A 7th character applies in this family. Confirm the documented encounter matches the character assigned. See the official 7th-character definitions and this code’s variants
  2. Laterality is coded in this family. Confirm the documented side matches the code — the opposite-side siblings are in the relationships section. See the opposite-side sibling codes
  3. 1 Use Additional Code instruction — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  4. 3 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  5. 3 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

Other codes that name M84.374A or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: M84.4 — Pathological fracture, not elsewhere classified (via M84.3.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

MS-DRG Grouper Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Potential MS-DRG participation — not a DRG assignment.

Named in the grouper logic of 3 MS-DRGs: DRG 542 (MDC 08), DRG 543 (MDC 08), DRG 544 (MDC 08).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):MUS016 — Stress fracture, initial encounter (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same condition, opposite side

Same category and title, differing only in which side of the body is affected.

M84.375A — Stress fracture, left foot, initial encounter for fracture (left)Compare M84.374A vs M84.375A →, M84.376A — Stress fracture, unspecified foot, initial encounter for fracture (unspecified)Compare M84.374A vs M84.376A →

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Stress fracture, initial encounter).

M84.346A — Stress fracture, unspecified finger(s), initial encounter for fracture, M84.350A — Stress fracture, pelvis, initial encounter for fracture, M84.351A — Stress fracture, right femur, initial encounter for fracture, M84.352A — Stress fracture, left femur, initial encounter for fracture, M84.353A — Stress fracture, unspecified femur, initial encounter for fracture, M84.359A — Stress fracture, hip, unspecified, initial encounter for fracture, M84.361A — Stress fracture, right tibia, initial encounter for fracture, M84.362A — Stress fracture, left tibia, initial encounter for fracture, M84.363A — Stress fracture, right fibula, initial encounter for fracture, M84.364A — Stress fracture, left fibula, initial encounter for fracture, M84.369A — Stress fracture, unspecified tibia and fibula, initial encounter for fracture, M84.371A — Stress fracture, right ankle, initial encounter for fracture, M84.372A — Stress fracture, left ankle, initial encounter for fracture, M84.373A — Stress fracture, unspecified ankle, initial encounter for fracture, M84.375A — Stress fracture, left foot, initial encounter for fracture, M84.376A — Stress fracture, unspecified foot, initial encounter for fracture, M84.377A — Stress fracture, right toe(s), initial encounter for fracture, M84.378A — Stress fracture, left toe(s), initial encounter for fracture, M84.379A — Stress fracture, unspecified toe(s), initial encounter for fracture, M84.38XA — Stress fracture, other site, initial encounter for fracture, +35 more

Contextual Map

Every relationship of M84.374A in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

Referenced by Excludes1 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]

Frequently Asked Questions (FAQ) & Clinical Guidance

Does M84.374A require a 7th character?

Yes. The appropriate 7th character is to be added to each code from subcategory M84.3:.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to M84.374A in its code family, with their registry titles.

View all codes in the M84 family