M84.3: Stress fracture
M84.3 is a non-billable header ICD-10-CM code for stress fracture. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.
This code requires a 7th character
The appropriate 7th character is to be added to each code from subcategory M84.3:
- 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
Excludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Excludes2: not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Use additional code
Add a secondary code to capture the detail described below.
- external cause code(s) to identify the cause of the stress fracture
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Fatigue fracture
- March fracture
- Stress fracture NOS
- Stress reaction
Excludes2 inherited from the categories above M84.3
Not part of this code, but both may be coded when both are present.
Written on M84: Disorder of continuity of bone
- traumatic fracture of bone-see fracture, by site
Other codes that can never be billed with M84.3
Their own Excludes1 notes name this code, so the conflict is not listed above.
- M84.4Pathological fracture, not elsewhere classified
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Code history
Unchanged in every release from FY2024 to FY2027.
Code to one of these instead M84.3
9 child codes. Green means billable.
- M84.30Stress fracture, unspecified site
- M84.31Stress fracture, shoulder
- M84.32Stress fracture, humerus
- M84.33Stress fracture, ulna and radius
- M84.34Stress fracture, hand and fingers
- M84.35Stress fracture, pelvis and femur
- M84.36Stress fracture, tibia and fibula
- M84.37Stress fracture, ankle, foot and toes
- M84.38Stress fracture, other site