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M84.68XK ICD-10-CM Code: Pathological fracture in other disease, 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 in other disease, other site, subsequent encounter for fracture with nonunion is a billable ICD-10-CM diagnosis code (M84.68K).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for M84.68XK 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.

  • traumatic fracture of bone-see fracture, by site

Code Also

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

  • underlying condition

Frequently Compared Codes

The official Excludes notes on M84.68XK 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

Official ICD-10-CM tabular notes on other codes that name M84.68XK or its code family.

1 Excludes1 notes: M84.4 (via M84.6.-).

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.

Contextual Map

Every relationship of M84.68XK 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 M84.6.-): “pathological fracture in other disease (M84.6-)” · 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]
  • M84.674P — 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]
  • M84.675G — Pathological fracture in other disease, left foot, subsequent encounter for fracture with delayed healing [Sibling]
  • M84.675K — Pathological fracture in other disease, left foot, subsequent encounter for fracture with nonunion [Sibling]
  • and 32 more

Frequently Asked Questions (FAQ) & Clinical Guidance

Does M84.68XK 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 M84.68XK in its code family, with their registry titles.

  • 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
  • M84.68XD — Pathological fracture in other disease, other site, subsequent encounter for fracture with routine healing
  • M84.68XG — Pathological fracture in other disease, other site, subsequent encounter for fracture with delayed healing
  • 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
  • M84.75 — Atypical femoral fracture
  • M84.750 — Atypical femoral fracture, unspecified

View all codes in the M84 family