M84.474
M84.474 — Pathological fracture, right foot
Non-billable headerICD-10-CMright
M84.474 is a non-billable header ICD-10-CM code for pathological fracture, right foot. 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
M84.474 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 M84.474
6 child codes. Green means billable.
- M84.474APathological fracture, right foot, initial encounter for fracture
- M84.474DPathological fracture, right foot, subsequent encounter for fracture with routine healing
- M84.474GPathological fracture, right foot, subsequent encounter for fracture with delayed healing
- M84.474KPathological fracture, right foot, subsequent encounter for fracture with nonunion
- M84.474PPathological fracture, right foot, subsequent encounter for fracture with malunion
- M84.474SPathological fracture, right foot, sequela
Related codes at this level
Codes that share M84.47. If M84.474 is not quite right, the correct code is usually one of these.
- M84.471Pathological fracture, right ankle
- M84.472Pathological fracture, left ankle
- M84.473Pathological fracture, unspecified ankle
- M84.475Pathological fracture, left foot
- M84.476Pathological fracture, unspecified foot
- M84.477Pathological fracture, right toe(s)
- M84.478Pathological fracture, left toe(s)
- M84.479Pathological fracture, unspecified toe(s)
Questions about M84.474
- Is M84.474 a billable ICD-10-CM code?
- No. M84.474 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does M84.474 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).