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M84.48XS ICD-10-CM Code: Pathological fracture, other 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, other site, sequela is a billable ICD-10-CM diagnosis code (M84.48S).

Official Tabular Instructional Notes

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

Contextual Map

Every relationship of M84.48XS 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]
  • M84.478 — 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]
  • M84.478P — Pathological fracture, left toe(s), subsequent encounter for fracture with malunion [Sibling]
  • M84.478S — Pathological fracture, left toe(s), sequela [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 M84.48XS or its code family.

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

Frequently Asked Questions (FAQ) & Clinical Guidance

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

  • 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
  • M84.48XK — Pathological fracture, other site, subsequent encounter for fracture with nonunion
  • M84.48XP — Pathological fracture, other site, subsequent encounter for fracture with malunion
  • 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
  • M84.50XD — Pathological fracture in neoplastic disease, unspecified site, subsequent encounter for fracture with routine healing
  • M84.50XG — Pathological fracture in neoplastic disease, unspecified site, subsequent encounter for fracture with delayed healing

View all codes in the M84 family