Is M84.30XS a billable ICD-10-CM code?

Yes. M84.30XS is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does M84.30XS sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Disorders of bone density and structure (M80-M85).

What cannot be coded together with M84.30XS?

M84.30XS carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M84.30XS (M84.3) and apply to it just the same.

M84.30XS

M84.30XS — Stress fracture, unspecified site, sequela

Billable / specific codeICD-10-CM

M84.30XS is a billable, specific ICD-10-CM code for stress fracture, unspecified site, sequela. It is valid for submission on a claim.

7th character "S" — sequela

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 inherited from the categories above M84.30XS

These are not written on M84.30XS, but they bind it: a note on a category applies to every code beneath it. Billing M84.30XS with anything listed here is a denial.

Written on M84.3 — Stress fracture

pathological fracture NOS (M84.4.-)
pathological fracture due to osteoporosis (M80.-)
traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)

Excludes2 inherited from the categories above M84.30XS

Also inherited, and the opposite of Excludes1: these conditions are not part of M84.30XS, but a patient can have both, so you may code both.

Written on M84.3 — Stress fracture

personal history of (healed) stress (fatigue) fracture (Z87.312)
stress fracture of vertebra (M48.4-)

Written on M84 — Disorder of continuity of bone

traumatic fracture of bone-see fracture, by site

Risk adjustment

M84.30XS does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

M84.30XS is named in 8 Medicare coverage policies — 1 listing it as supporting medical necessity, and 7 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
A58883Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
A58893Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered

Code history

M84.30XS has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share M84.30. If M84.30XS is not quite right, the correct code is usually one of these.

Questions about M84.30XS

Is M84.30XS a billable ICD-10-CM code?: Yes. M84.30XS is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does M84.30XS sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Disorders of bone density and structure (M80-M85).
What cannot be coded together with M84.30XS?: M84.30XS carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M84.30XS (M84.3) and apply to it just the same.