M84.54
M84.54 — Pathological fracture in neoplastic disease, hand
Non-billable headerICD-10-CM
M84.54 is a non-billable header ICD-10-CM code for pathological fracture in neoplastic disease, hand. 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 M84.5:
- 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
M84.54 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 M84.54
3 child codes. Green means billable.
Related codes at this level
Codes that share M84.5. If M84.54 is not quite right, the correct code is usually one of these.
- M84.50Pathological fracture in neoplastic disease, unspecified site
- M84.51Pathological fracture in neoplastic disease, shoulder
- M84.52Pathological fracture in neoplastic disease, humerus
- M84.53Pathological fracture in neoplastic disease, ulna and radius
- M84.55Pathological fracture in neoplastic disease, pelvis and femur
- M84.56Pathological fracture in neoplastic disease, tibia and fibula
- M84.57Pathological fracture in neoplastic disease, ankle and foot
- M84.58Pathological fracture in neoplastic disease, other specified site
Questions about M84.54
- Is M84.54 a billable ICD-10-CM code?
- No. M84.54 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does M84.54 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).