Alphabetic Index FY2027

M84.522S

Pathological fracture in neoplastic disease, left humerus, sequela

FY2027Chapter 13: Diseases of the musculoskeletal system and connective tissue/M80–M85 Disorders of bone density and structure

BillableComplete code, valid to report
Care settingsHome Health Primary · Musculoskeletal Rehabilitation

M84.522S (also written M84522S) is a billable ICD-10-CM diagnosis code for pathological fracture in neoplastic disease, left humerus, sequela. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 928 codes in category M84 (Disorder of continuity of bone). Its 7th character, S, means sequela. Its coding notes include a Code also instruction and 11 Excludes2 entries.

7th character

Category M84.5 requires a 7th character.

Assembled code M84.522S Open code

Guidelines tips

From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.

Sequencing depends on the focus of treatment: the fracture or the neoplasm.

Guidelines I.C.2.l.6Pathological fracture due to a neoplasmRead the official text

7th character A applies while the patient is in active treatment, regardless of which provider sees them. D is for routine care during healing after active treatment ends.

Guidelines I.C.13.cPathological fractures: the 7th characterRead the official text

Code also

Two codes may be needed to describe the condition. This note gives no sequencing order.

Inherited from M84.5 Pathological fracture in neoplastic disease
  • underlying neoplasm

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Inherited from M84 Disorder of continuity of bone
  • traumatic fracture of bone-see fracture, by site
Also from chapter/block level (10 notes)
Inherited from Chapter 13 Diseases of the musculoskeletal system and connective tissue
  • arthropathic psoriasis (L40.5-)
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • compartment syndrome (traumatic) (T79.A-)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the Musculoskeletal Rehabilitation clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

Notes

Also from chapter/block level (1 note)
Inherited from Chapter 13 Diseases of the musculoskeletal system and connective tissue
  • Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition