M84.58XA ICD-10-CM Code: Pathological fracture in neoplastic disease, other specified 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 456 — SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC (MDC 08)
- MS-DRG 457 — SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC (MDC 08)
- MS-DRG 458 — SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC (MDC 08)
- 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
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for M84.58XA in the official ICD-10-CM tabular list.
Inclusion Terms
Alternative terms the tabular list files under this code.
- Pathological fracture in neoplastic disease, vertebrae
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
- Billable — reportable as written.
- 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 M84.58XA 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-)”
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 456 — SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC [MS-DRG]: “SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC (MDC 08)”
- DRG 457 — SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC [MS-DRG]: “SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC (MDC 08)”
- DRG 458 — SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC [MS-DRG]: “SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC (MDC 08)”
- 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)”
- and 1 more
Nearest codes (40)
- M84 — Disorder of continuity of bone [Sibling]
- M84.574D — Pathological fracture in neoplastic disease, right foot, subsequent encounter for fracture with routine healing [Sibling]
- M84.574G — Pathological fracture in neoplastic disease, right foot, subsequent encounter for fracture with delayed healing [Sibling]
- M84.574K — Pathological fracture in neoplastic disease, right foot, subsequent encounter for fracture with nonunion [Sibling]
- M84.574P — Pathological fracture in neoplastic disease, right foot, subsequent encounter for fracture with malunion [Sibling]
- M84.574S — Pathological fracture in neoplastic disease, right foot, sequela [Sibling]
- M84.575 — Pathological fracture in neoplastic disease, left foot [Sibling]
- M84.575A — Pathological fracture in neoplastic disease, left foot, initial encounter for fracture [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 8 MS-DRGs: DRG 456 (MDC 08), DRG 457 (MDC 08), DRG 458 (MDC 08), 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 M84.58XA or its code family.
1 Excludes1 notes: M84.4 (via M84.5.-).
Frequently Asked Questions (FAQ) & Clinical Guidance
Does M84.58XA 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 M84.58XA in its code family, with their registry titles.
- M84.576G — Pathological fracture in neoplastic disease, unspecified foot, subsequent encounter for fracture with delayed healing
- M84.576K — Pathological fracture in neoplastic disease, unspecified foot, subsequent encounter for fracture with nonunion
- M84.576P — Pathological fracture in neoplastic disease, unspecified foot, subsequent encounter for fracture with malunion
- M84.576S — Pathological fracture in neoplastic disease, unspecified foot, sequela
- M84.58 — Pathological fracture in neoplastic disease, other specified site
- M84.58XD — Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing
- M84.58XG — Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with delayed healing
- M84.58XK — Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with nonunion
- M84.58XP — Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with malunion
- M84.58XS — Pathological fracture in neoplastic disease, other specified site, sequela