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v1.0.0
ICD-10 Guide
ICD-10 CodesM84.350

M84.350

Billable

Stress fracture, pelvis

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M84.350 is a billable code used to indicate a diagnosis of stress fracture, pelvis.

Key Diagnostic Point:

A stress fracture of the pelvis is a small crack in the pelvic bone that occurs due to repetitive stress or overuse, often seen in athletes or individuals with increased physical activity. This condition is particularly prevalent in those with underlying bone density disorders, such as osteoporosis, where the bones are more fragile and susceptible to fractures. The pelvis, being a weight-bearing structure, can experience stress fractures from activities like running, jumping, or heavy lifting. Symptoms typically include localized pain in the pelvic region, which may worsen with activity and improve with rest. Diagnosis is often confirmed through imaging studies, such as X-rays or MRI, which can reveal the fracture and assess the surrounding bone density. Treatment generally involves rest, modification of activities, and in some cases, physical therapy to strengthen the surrounding muscles and improve bone health. Understanding the relationship between bone metabolism, density disorders, and stress fractures is crucial for effective management and prevention of future injuries.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between stress fractures and other types of fractures
  • Understanding the impact of underlying bone density disorders
  • Variability in presentation and symptoms among patients
  • Need for precise documentation of activity levels and risk factors

Audit Risk Factors

  • Inadequate documentation of the patient's activity level
  • Failure to document underlying bone density disorders
  • Misclassification of the type of fracture
  • Lack of imaging results in the medical record

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the mechanism of injury, imaging results, and treatment plan.

Common Clinical Scenarios

Athletes presenting with pelvic pain after increased training intensity.

Billing Considerations

Ensure documentation reflects the patient's activity level and any pre-existing conditions affecting bone density.

Endocrinology

Documentation Requirements

Assessment of bone density through DEXA scans and history of osteoporosis.

Common Clinical Scenarios

Patients with osteoporosis presenting with stress fractures.

Billing Considerations

Document any medications affecting bone metabolism, such as bisphosphonates.

Coding Guidelines

Inclusion Criteria

Use M84.350 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture type and any underlying conditions
  • Include details about the patient's activity level and any relevant imaging studies

Exclusion Criteria

Do NOT use M84.350 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

73630CPT Code

Radiologic examination, pelvis, two views

Clinical Scenario

Used to confirm the diagnosis of a stress fracture.

Documentation Requirements

Document the reason for the imaging and findings.

Specialty Considerations

Orthopedic specialists should ensure imaging correlates with clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of stress fractures, improving the ability to capture the nuances of bone health and related conditions, which is essential for appropriate treatment and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stress fractures, improving the ability to capture the nuances of bone health and related conditions, which is essential for appropriate treatment and reimbursement.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common causes of stress fractures in the pelvis?

Common causes include repetitive activities such as running, jumping, or heavy lifting, especially in individuals with low bone density or osteoporosis.

How can stress fractures be prevented?

Prevention strategies include gradual increases in activity levels, proper footwear, strength training, and ensuring adequate calcium and vitamin D intake.