M84.43 is the authoritative medical code for Pathological fracture, ulna and radius. This classification is used in medical billing and clinical recording to specify the clinical criteria for pathological fracture, ulna and radius (ICD-10-CM M84.43), ensuring healthcare documentation aligns with current federal coding standards.
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Official Registry Overview & Definition
Pathological fracture, ulna and radius is a non-billable ICD-10-CM category code M84.43. A more specific billable subcode must be selected for claims submission. Excludes1 (not coded here): collapsed vertebra NEC M48.5; pathological fracture in neoplastic disease M84.5-; pathological fracture in osteoporosis M80.-; pathological fracture in other disease M84.6-; stress fracture M84.3-; traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-). Excludes2 (not included here): personal history of healed pathological fracture Z87.311; traumatic fracture of bone-see fracture, by site. 7th character: The appropriate 7th character is to be added to each code from subcategory M84.4:.
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for M84.43 in the official ICD-10-CM tabular list.
Excludes1 — Not Coded Here
Conditions that can never be reported with this code; the two are mutually exclusive.
- collapsed vertebra NEC M48.5
- pathological fracture in neoplastic disease M84.5-
- pathological fracture in osteoporosis M80.-
- pathological fracture in other disease M84.6-
- stress fracture M84.3-
- traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- personal history of healed pathological fracture Z87.311
- traumatic fracture of bone-see fracture, by site
Frequently Asked Questions (FAQ) & Clinical Guidance
Can M84.43 be billed directly?
No. M84.43 (Pathological fracture, ulna and radius) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
Does M84.43 require a 7th character?
Yes. The appropriate 7th character is to be added to each code from subcategory M84.4:.
What can't be coded together with M84.43?
Per official ICD-10-CM Excludes1 instructions, M84.43 must not be reported together with: collapsed vertebra NEC (M48.5); pathological fracture in neoplastic disease (M84.5-); pathological fracture in osteoporosis (M80.-); pathological fracture in other disease (M84.6-).
Can M84.43 be reported alongside related conditions?
Per official ICD-10-CM Excludes2 instructions, M84.43 and the following are not considered part of each other and may both be reported when both conditions are present: personal history of (healed) pathological fracture (Z87.311); traumatic fracture of bone-see fracture, by site.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to M84.43 in its code family, with their registry titles.
- M84.319S — Stress fracture, unspecified shoulder, sequela
- M84.32 — Stress fracture, humerus
- M84.321 — Stress fracture, right humerus
- M84.321A — Stress fracture, right humerus, initial encounter for fracture
- M84.321D — Stress fracture, right humerus, subsequent encounter for fracture with routine healing
- M84.321G — Stress fracture, right humerus, subsequent encounter for fracture with delayed healing
- M84.321K — Stress fracture, right humerus, subsequent encounter for fracture with nonunion
- M84.321P — Stress fracture, right humerus, subsequent encounter for fracture with malunion
- M84.321S — Stress fracture, right humerus, sequela
- M84.322 — Stress fracture, left humerus
View all 40 codes in the M84 family