M84.58XG

M84.58XG: Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with delayed healing

Billable / specific codeICD-10-CM

M84.58XG is a billable, specific ICD-10-CM code for pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with delayed healing. It is valid for submission on a claim.

Check M84.58XG with the rest of the claim: free scrubber

7th character "G": subsequent encounter for fracture with delayed healing

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

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Pathological fracture in neoplastic disease, vertebrae

Excludes2 inherited from the categories above M84.58XG

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

M84.58XG is named in 11 Medicare coverage policies: 4 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.