M84.68XD ICD-10-CM Code: Pathological fracture in other disease, other site, subsequent encounter for fracture with routine healing
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
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for M84.68XD 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).
- pathological fracture in osteoporosis (M80.-) Compare M84.68XD vs M80 →
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 condition
Change history
No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.
Verify Before Coding
- Billable — reportable as written.
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 M84.68XD 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
- M84.68 — Pathological fracture in other disease, other site [Hierarchy]
Referenced by Excludes1 notes
- M84.4 — Pathological fracture, not elsewhere classified [Excludes1](via M84.6.-): “pathological fracture in other disease (M84.6-)”
Clinical classification (CCSR)
- MUS015 — Pathological fracture, subsequent encounter [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)”
Nearest codes (40)
- M84 — Disorder of continuity of bone [Sibling]
- M84.674G — Pathological fracture in other disease, right foot, subsequent encounter for fracture with delayed healing [Sibling]
- M84.674K — Pathological fracture in other disease, right foot, subsequent encounter for fracture with nonunion [Sibling]
- M84.674P — Pathological fracture in other disease, right foot, subsequent encounter for fracture with malunion [Sibling]
- M84.674S — Pathological fracture in other disease, right foot, sequela [Sibling]
- M84.675 — Pathological fracture in other disease, left foot [Sibling]
- M84.675A — Pathological fracture in other disease, left foot, initial encounter for fracture [Sibling]
- M84.675D — Pathological fracture in other disease, left foot, subsequent encounter for fracture with routine healing [Sibling]
- and 32 more
Referenced by Other Codes
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.
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 M84.68XD or its code family.
1 Excludes1 notes: M84.4 (via M84.6.-).
Frequently Asked Questions (FAQ) & Clinical Guidance
Does M84.68XD require a 7th character?
Yes. The appropriate 7th character is to be added to each code from subcategory M84.6:.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to M84.68XD in its code family, with their registry titles.
- M84.676K — Pathological fracture in other disease, unspecified foot, subsequent encounter for fracture with nonunion
- M84.676P — Pathological fracture in other disease, unspecified foot, subsequent encounter for fracture with malunion
- M84.676S — Pathological fracture in other disease, unspecified foot, sequela
- M84.68 — Pathological fracture in other disease, other site
- M84.68XA — Pathological fracture in other disease, other site, initial encounter for fracture
- M84.68XG — Pathological fracture in other disease, other site, subsequent encounter for fracture with delayed healing
- M84.68XK — Pathological fracture in other disease, other site, subsequent encounter for fracture with nonunion
- M84.68XP — Pathological fracture in other disease, other site, subsequent encounter for fracture with malunion
- M84.68XS — Pathological fracture in other disease, other site, sequela
- M84.7 — Nontraumatic fracture, not elsewhere classified