M84.431: Pathological fracture, right ulna
M84.431 is a non-billable header ICD-10-CM code for pathological fracture, right ulna. 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
Excludes1 inherited from the categories above M84.431
A category’s note binds every code beneath it.
Written on M84.4: Pathological fracture, not elsewhere classified
Excludes2 inherited from the categories above M84.431
Not part of this code, but both may be coded when both are present.
Written on M84.4: Pathological fracture, not elsewhere classified
- personal history of (healed) pathological fracture (Z87.311)
Written on M84: Disorder of continuity of bone
- traumatic fracture of bone-see fracture, by site
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 M84.431
6 child codes. Green means billable.
- M84.431APathological fracture, right ulna, initial encounter for fracture
- M84.431DPathological fracture, right ulna, subsequent encounter for fracture with routine healing
- M84.431GPathological fracture, right ulna, subsequent encounter for fracture with delayed healing
- M84.431KPathological fracture, right ulna, subsequent encounter for fracture with nonunion
- M84.431PPathological fracture, right ulna, subsequent encounter for fracture with malunion
- M84.431SPathological fracture, right ulna, sequela