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ICD-10/M84.40XS

M84.40XS ICD-10-CM Code: Pathological fracture, unspecified site, sequela

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

Inpatient Payment Groups (MS-DRG)

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 559 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC (MDC 08)
  • MS-DRG 560 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC (MDC 08)
  • MS-DRG 561 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE 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.

Official Registry Overview & Definition

Pathological fracture, unspecified site, sequela is a billable ICD-10-CM diagnosis code (M84.40S).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for M84.40XS in the official ICD-10-CM tabular list.

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).

Excludes2 — Not Included Here

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

Change history

No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.

Verify Before Coding

  • Billable — reportable as written.

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

Contextual Map

Every relationship of M84.40XS 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

  • M00-M99 — Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) (M00-M99) [Hierarchy]
  • M80-M85 — Disorders of bone density and structure [Hierarchy]

Referenced by Excludes1 notes

  • M48.4 — Fatigue fracture of vertebra [Excludes1](via M84.4.-): “pathological fracture NOS (M84.4-)” · check together
  • M48.5 — Collapsed vertebra, not elsewhere classified [Excludes1](via M84.4.-): “pathological fracture NOS (M84.4-)” · check together

Clinical classification (CCSR)

  • MUS020 — Pathological, stress and atypical fractures, sequela [CCSR]

Potential MS-DRG

  • DRG 559 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC [MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC (MDC 08)”
  • DRG 560 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC [MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC (MDC 08)”
  • DRG 561 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC [MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC (MDC 08)”

MDC crossing · procedures (18508)

  • MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue [MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 005T0ZZ — Destruction of Spinal Meninges, Open Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T3ZZ — Destruction of Spinal Meninges, Percutaneous Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T4ZZ — Destruction of Spinal Meninges, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Endoscopic Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0Z3 — Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0ZZ — Destruction of Cervical Spinal Cord, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • and 18503 more

Nearest codes (40)

  • M84 — Disorder of continuity of bone [Sibling]
  • M84.379A — Stress fracture, unspecified toe(s), initial encounter for fracture [Sibling]
  • M84.379D — Stress fracture, unspecified toe(s), subsequent encounter for fracture with routine healing [Sibling]
  • M84.379G — Stress fracture, unspecified toe(s), subsequent encounter for fracture with delayed healing [Sibling]
  • M84.379K — Stress fracture, unspecified toe(s), subsequent encounter for fracture with nonunion [Sibling]
  • M84.379P — Stress fracture, unspecified toe(s), subsequent encounter for fracture with malunion [Sibling]
  • M84.379S — Stress fracture, unspecified toe(s), sequela [Sibling]
  • M84.38 — Stress fracture, other site [Sibling]
  • and 32 more

Referenced by Other Codes

Clinical classification (AHRQ CCSR):MUS020 — Pathological, stress and atypical fractures, sequela (default).

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

Potential MS-DRG Relationships (FY2026)

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

Named in the grouper logic of 3 MS-DRGs: DRG 559 (MDC 08), DRG 560 (MDC 08), DRG 561 (MDC 08).

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

Official ICD-10-CM tabular notes on other codes that name M84.40XS or its code family.

2 Excludes1 notes: M48.4 (via M84.4.-), M48.5 (via M84.4.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Does M84.40XS require a 7th character?

Yes. The appropriate 7th character is to be added to each code from subcategory M84.4:.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to M84.40XS in its code family, with their registry titles.

  • M84.40XA — Pathological fracture, unspecified site, initial encounter for fracture
  • M84.40XD — Pathological fracture, unspecified site, subsequent encounter for fracture with routine healing
  • M84.40XG — Pathological fracture, unspecified site, subsequent encounter for fracture with delayed healing
  • M84.40XK — Pathological fracture, unspecified site, subsequent encounter for fracture with nonunion
  • M84.40XP — Pathological fracture, unspecified site, subsequent encounter for fracture with malunion
  • M84.41 — Pathological fracture, shoulder
  • M84.411 — Pathological fracture, right shoulder
  • M84.411A — Pathological fracture, right shoulder, initial encounter for fracture
  • M84.411D — Pathological fracture, right shoulder, subsequent encounter for fracture with routine healing
  • M84.411G — Pathological fracture, right shoulder, subsequent encounter for fracture with delayed healing

View all codes in the M84 family