M84.43
M84.43 — Pathological fracture, ulna and radius
Non-billable headerICD-10-CM
M84.43 is a non-billable header ICD-10-CM code for pathological fracture, ulna and radius. 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
M84.43 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 M84.43
5 child codes. Green means billable.
Related codes at this level
Codes that share M84.4. If M84.43 is not quite right, the correct code is usually one of these.
- M84.40Pathological fracture, unspecified site
- M84.41Pathological fracture, shoulder
- M84.42Pathological fracture, humerus
- M84.44Pathological fracture, hand and fingers
- M84.45Pathological fracture, femur and pelvis
- M84.46Pathological fracture, tibia and fibula
- M84.47Pathological fracture, ankle, foot and toes
- M84.48Pathological fracture, other site
Questions about M84.43
- Is M84.43 a billable ICD-10-CM code?
- No. M84.43 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does M84.43 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).