M84.411
M84.411 — Pathological fracture, right shoulder
Non-billable headerICD-10-CMright
M84.411 is a non-billable header ICD-10-CM code for pathological fracture, right shoulder. 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 M84.4:
- 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
Risk adjustment
M84.411 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.
Code to one of these instead M84.411
6 child codes. Green means billable.
- M84.411APathological fracture, right shoulder, initial encounter for fracture
- M84.411DPathological fracture, right shoulder, subsequent encounter for fracture with routine healing
- M84.411GPathological fracture, right shoulder, subsequent encounter for fracture with delayed healing
- M84.411KPathological fracture, right shoulder, subsequent encounter for fracture with nonunion
- M84.411PPathological fracture, right shoulder, subsequent encounter for fracture with malunion
- M84.411SPathological fracture, right shoulder, sequela
Related codes at this level
Codes that share M84.41. If M84.411 is not quite right, the correct code is usually one of these.
Questions about M84.411
- Is M84.411 a billable ICD-10-CM code?
- No. M84.411 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does M84.411 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).