M84.611
M84.611 — Pathological fracture in other disease, right shoulder
Non-billable headerICD-10-CMright
M84.611 is a non-billable header ICD-10-CM code for pathological fracture in other disease, right shoulder. 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 M84.6:
- 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
M84.611 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 M84.611
6 child codes. Green means billable.
- M84.611APathological fracture in other disease, right shoulder, initial encounter for fracture
- M84.611DPathological fracture in other disease, right shoulder, subsequent encounter for fracture with routine healing
- M84.611GPathological fracture in other disease, right shoulder, subsequent encounter for fracture with delayed healing
- M84.611KPathological fracture in other disease, right shoulder, subsequent encounter for fracture with nonunion
- M84.611PPathological fracture in other disease, right shoulder, subsequent encounter for fracture with malunion
- M84.611SPathological fracture in other disease, right shoulder, sequela
Related codes at this level
Codes that share M84.61. If M84.611 is not quite right, the correct code is usually one of these.
Questions about M84.611
- Is M84.611 a billable ICD-10-CM code?
- No. M84.611 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does M84.611 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).