M84.345A — Stress fracture, left finger(s), initial encounter for fracture
M84.345A is a billable, specific ICD-10-CM code for stress fracture, left finger(s), initial encounter for fracture. It is valid for submission on a claim.
7th character "A" — initial encounter for fracture
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 M84.345A
These are not written on M84.345A, but they bind it: a note on a category applies to every code beneath it. Billing M84.345A with anything listed here is a denial.
Excludes2 inherited from the categories above M84.345A
Also inherited, and the opposite of Excludes1: these conditions are not part of M84.345A, but a patient can have both, so you may code both.
Written on M84.3 — Stress fracture
Written on M84 — Disorder of continuity of bone
- traumatic fracture of bone-see fracture, by site
Risk adjustment
M84.345A 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
M84.345A is named in 9 Medicare coverage policies — 2 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
M84.345A 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 M84.345. If M84.345A is not quite right, the correct code is usually one of these.
- M84.345DStress fracture, left finger(s), subsequent encounter for fracture with routine healing
- M84.345GStress fracture, left finger(s), subsequent encounter for fracture with delayed healing
- M84.345KStress fracture, left finger(s), subsequent encounter for fracture with nonunion
- M84.345PStress fracture, left finger(s), subsequent encounter for fracture with malunion
- M84.345SStress fracture, left finger(s), sequela
Questions about M84.345A
- Is M84.345A a billable ICD-10-CM code?
- Yes. M84.345A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M84.345A 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 M84.345A?
- M84.345A 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 M84.345A (M84.3) and apply to it just the same.