M84.551S

M84.551S: Pathological fracture in neoplastic disease, right femur, sequela

Billable / specific codeICD-10-CMright

M84.551S is a billable, specific ICD-10-CM code for pathological fracture in neoplastic disease, right femur, sequela. It is valid for submission on a claim.

Check M84.551S with the rest of the claim: free scrubber

7th character "S": sequela

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

Excludes2 inherited from the categories above M84.551S

Not part of this code, but both may be coded when both are present.

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.

Medicare coverage

M84.551S is named in 23 Medicare coverage policies: 16 listing it as supporting medical necessity, and 7 listing it as NOT covered. Which one applies depends on your Medicare contractor.

A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
A58883Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
A58893Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered

Code history

Unchanged in every release from FY2024 to FY2027.