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ICD-10/M84.50XA

M84.50XA ICD-10-CM Code: Pathological fracture in neoplastic disease, unspecified site, initial encounter for fracture

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 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)
  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)

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 in neoplastic disease, unspecified site, initial encounter for fracture is a billable ICD-10-CM diagnosis code (M84.50A).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for M84.50XA in the official ICD-10-CM tabular list.

Excludes2 — Not Included Here

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

  • traumatic fracture of bone-see fracture, by site

Code Also

Additional codes that may be required to fully describe the encounter.

  • underlying neoplasm

Change history

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

Verify Before Coding

  • CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

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 M84.50XA 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

  • M84.4 — Pathological fracture, not elsewhere classified [Excludes1](via M84.5.-): “pathological fracture in neoplastic disease (M84.5-)” · check together

Clinical classification (CCSR)

  • MUS014 — Pathological fracture, initial encounter [CCSR]
  • NEO074 — Conditions due to neoplasm or the treatment of neoplasm [CCSR]

Potential MS-DRG

  • CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”
  • DRG 542 — PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC [MS-DRG]: “PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC (MDC 08)”
  • DRG 543 — PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC [MS-DRG]: “PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC (MDC 08)”
  • DRG 544 — PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC [MS-DRG]: “PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC (MDC 08)”
  • DRG 791 — PREMATURITY WITH MAJOR PROBLEMS [MS-DRG]: “PREMATURITY WITH MAJOR PROBLEMS (MDC 15)”
  • DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS [MS-DRG]: “FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)”

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.”
  • MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period [MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — 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]
  • M84.478G — 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]
  • M84.479 — Pathological fracture, unspecified toe(s) [Sibling]
  • M84.479A — Pathological fracture, unspecified toe(s), initial encounter for fracture [Sibling]
  • M84.479D — Pathological fracture, unspecified toe(s), subsequent encounter for fracture with routine healing [Sibling]
  • and 32 more

Referenced by Other Codes

Clinical classification (AHRQ CCSR):MUS014 — Pathological fracture, initial encounter (default); NEO074 — Conditions due to neoplasm or the treatment of neoplasm.

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)

CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 214 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 5 MS-DRGs: DRG 542 (MDC 08), DRG 543 (MDC 08), DRG 544 (MDC 08), DRG 791 (MDC 15), DRG 793 (MDC 15).

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 M84.50XA or its code family.

1 Excludes1 notes: M84.4 (via M84.5.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Does M84.50XA require a 7th character?

Yes. The appropriate 7th character is to be added to each code from subcategory M84.5:.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to M84.50XA in its code family, with their registry titles.

  • M84.48XK — Pathological fracture, other site, subsequent encounter for fracture with nonunion
  • M84.48XP — Pathological fracture, other site, subsequent encounter for fracture with malunion
  • M84.48XS — Pathological fracture, other site, sequela
  • M84.5 — Pathological fracture in neoplastic disease
  • M84.50 — Pathological fracture in neoplastic disease, unspecified site
  • 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
  • M84.50XK — Pathological fracture in neoplastic disease, unspecified site, subsequent encounter for fracture with nonunion
  • M84.50XP — Pathological fracture in neoplastic disease, unspecified site, subsequent encounter for fracture with malunion
  • M84.50XS — Pathological fracture in neoplastic disease, unspecified site, sequela

View all codes in the M84 family