Pathological fracture, unspecified tibia and fibula, subsequent encounter for fracture with delayed healing
Billable / specific
M84.469G is a billable, specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes in FY2027.
Inclusion terms
Includes (from M84)
- Note: Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
Excludes1
Not coded here — never report together with this code.
- collapsed vertebra NEC (M48.5) (from M84.4)
- pathological fracture in neoplastic disease (M84.5-) (from M84.4)
- pathological fracture in osteoporosis (M80.-) (from M84.4)
- pathological fracture in other disease (M84.6-) (from M84.4)
- stress fracture (M84.3-) (from M84.4)
- traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-) (from M84.4)
Excludes2
Not included here — may be reported together when both conditions exist.
- personal history of (healed) pathological fracture (Z87.311) (from M84.4)
- arthropathic psoriasis (L40.5-) (from M84)
- certain conditions originating in the perinatal period (P04-P96) (from M84)
- certain infectious and parasitic diseases (A00-B99) (from M84)
- compartment syndrome (traumatic) (T79.A-) (from M84)
- complications of pregnancy, childbirth and the puerperium (O00-O9A) (from M84)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99) (from M84)
- endocrine, nutritional and metabolic diseases (E00-E88) (from M84)
- injury, poisoning and certain other consequences of external causes (S00-T88) (from M84)
- neoplasms (C00-D49) (from M84)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94) (from M84)
- traumatic fracture of bone-see fracture, by site (from M84)
7th character
The 7th character values that apply to this code (defined at M84.4). Use the placeholder "X" for missing positions.
| Character | Meaning |
|---|---|
| A | initial encounter for fracture |
| D | subsequent encounter for fracture with routine healing |
| G | subsequent encounter for fracture with delayed healing |
| K | subsequent encounter for fracture with nonunion |
| P | subsequent encounter for fracture with malunion |
| S | sequela |
Parent code
- M84.469Pathological fracture, unspecified tibia and fibulaNeeds 7th char
Related codes
- M84.469APathological fracture, unspecified tibia and fibula, initial encounter for fractureBillable
- M84.469DPathological fracture, unspecified tibia and fibula, subsequent encounter for fracture with routine healingBillable
- M84.469KPathological fracture, unspecified tibia and fibula, subsequent encounter for fracture with nonunionBillable
- M84.469PPathological fracture, unspecified tibia and fibula, subsequent encounter for fracture with malunionBillable
- M84.469SPathological fracture, unspecified tibia and fibula, sequelaBillable