Alphabetic Index FY2027

M84.56

Pathological fracture in neoplastic disease, tibia and fibula

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

Non-billable headerNot valid on its own. Use one of the more specific codes under it.

M84.56 is a non-billable ICD-10-CM code header for pathological fracture in neoplastic disease, tibia and fibula. Report a more specific code from it instead. It is part of the FY2027 code set, effective October 1, 2026. The more specific codes under it are M84.561 Pathological fracture in neoplastic disease, right tibia; M84.562 Pathological fracture in neoplastic disease, left tibia; M84.563 Pathological fracture in neoplastic disease, right fibula; M84.564 Pathological fracture in neoplastic disease, left fibula and 1 more. Its coding notes include a Code also instruction and 11 Excludes2 entries.

7th characters

Every code below needs one of these (defined at M84.5).

The appropriate 7th character is to be added to each code from subcategory M84.5:

  • Ainitial encounter for fracture
  • Dsubsequent encounter for fracture with routine healing
  • Gsubsequent encounter for fracture with delayed healing
  • Ksubsequent encounter for fracture with nonunion
  • Psubsequent encounter for fracture with malunion
  • Ssequela

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)

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

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 2 entries

More specific codes under M84.56 5