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M84.48XK ICD-10-CM Code: Pathological fracture, other site, subsequent encounter for fracture with nonunion

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 564 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC (MDC 08)
  • MS-DRG 565 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC (MDC 08)
  • MS-DRG 566 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES 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, other site, subsequent encounter for fracture with nonunion is a billable ICD-10-CM diagnosis code (M84.48K).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for M84.48XK 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.

Frequently Compared Codes

The official Excludes notes on M84.48XK name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

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

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.

Relationships & Classification

Other codes that name M84.48XK 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.

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

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 564 (MDC 08), DRG 565 (MDC 08), DRG 566 (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):MUS015 — Pathological fracture, subsequent 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 clinical category (CCSR)

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

+623 more

Contextual Map

Every relationship of M84.48XK 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)

  • MUS015 — Pathological fracture, subsequent encounter [CCSR]

Potential MS-DRG

  • DRG 564 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC [MS-DRG]: “OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC (MDC 08)”
  • DRG 565 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC [MS-DRG]: “OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC (MDC 08)”
  • DRG 566 — OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC [MS-DRG]: “OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES 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]
  • M84.477P — Pathological fracture, right toe(s), subsequent encounter for fracture with malunion [Sibling]
  • M84.477S — Pathological fracture, right toe(s), sequela [Sibling]
  • M84.478 — Pathological fracture, left toe(s) [Sibling]
  • M84.478A — Pathological fracture, left toe(s), initial encounter for fracture [Sibling]
  • M84.478D — Pathological fracture, left toe(s), subsequent encounter for fracture with routine healing [Sibling]
  • M84.478G — Pathological fracture, left toe(s), subsequent encounter for fracture with delayed healing [Sibling]
  • M84.478K — Pathological fracture, left toe(s), subsequent encounter for fracture with nonunion [Sibling]
  • and 32 more

Frequently Asked Questions (FAQ) & Clinical Guidance

Does M84.48XK 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 M84.48XK in its code family, with their registry titles.

  • M84.479S — Pathological fracture, unspecified toe(s), sequela
  • M84.48 — Pathological fracture, other site
  • M84.48XA — Pathological fracture, other site, initial encounter for fracture
  • M84.48XD — Pathological fracture, other site, subsequent encounter for fracture with routine healing
  • M84.48XG — Pathological fracture, other site, subsequent encounter for fracture with delayed healing
  • M84.48XP — Pathological fracture, other site, subsequent encounter for fracture with malunion
  • M84.48XS — Pathological fracture, other site, sequela
  • M84.5 — Pathological fracture in neoplastic disease
  • M84.50 — Pathological fracture in neoplastic disease, unspecified site
  • M84.50XA — Pathological fracture in neoplastic disease, unspecified site, initial encounter for fracture

View all codes in the M84 family