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ICD-10 Guide
ICD-10 CodesM84.352

M84.352

Billable

Stress fracture, left femur

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

Code Description

ICD-10 M84.352 is a billable code used to indicate a diagnosis of stress fracture, left femur.

Key Diagnostic Point:

A stress fracture of the left femur is a small crack in the bone that occurs due to repetitive force or overuse, often seen in athletes or individuals with increased physical activity. This condition is particularly prevalent in patients with underlying bone density disorders, such as osteoporosis, where the bone's structural integrity is compromised. Stress fractures can develop gradually, presenting with localized pain that worsens with activity and improves with rest. Diagnosis typically involves a thorough clinical evaluation, imaging studies such as X-rays or MRI, and consideration of the patient's medical history, including any factors contributing to decreased bone density. Treatment often includes rest, modification of activities, and in some cases, physical therapy to strengthen surrounding muscles and improve bone health. Monitoring bone metabolism and density is crucial, especially in patients at risk for osteoporosis, as these factors can significantly influence healing and recovery from stress fractures.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between stress fractures and other types of fractures
  • Understanding the patient's history of bone density disorders
  • Identifying the specific location and severity of the fracture
  • Documenting the patient's activity level and risk factors

Audit Risk Factors

  • Inadequate documentation of the patient's history of osteoporosis or other bone disorders
  • Failure to specify the exact location of the fracture
  • Lack of imaging results to support the diagnosis
  • Misclassification of the fracture type (stress vs. acute)

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, patient history, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with pain in the lower extremities after increased physical activity.

Billing Considerations

Consideration of the patient's overall bone health and any underlying conditions that may affect healing.

Endocrinology

Documentation Requirements

Documentation of bone density tests and metabolic evaluations.

Common Clinical Scenarios

Patients with osteoporosis presenting with fractures or bone pain.

Billing Considerations

Monitoring and managing underlying metabolic bone diseases that may contribute to stress fractures.

Coding Guidelines

Inclusion Criteria

Use M84.352 When
  • According to ICD
  • 10 guidelines, M84
  • 352 should be used when a stress fracture is confirmed through imaging and clinical evaluation
  • It is essential to document the specific location and any contributing factors such as osteoporosis

Exclusion Criteria

Do NOT use M84.352 When
  • Exclusion criteria include acute fractures or fractures due to trauma

Related ICD-10 Codes

Related CPT Codes

73630CPT Code

Radiologic examination, femur

Clinical Scenario

Used when imaging is required to confirm a stress fracture diagnosis.

Documentation Requirements

Radiology reports must be included in the patient's medical record.

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 accuracy of data collection and reimbursement processes. M84.352 provides a clear distinction from other fracture types, which aids in clinical management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stress fractures, improving the accuracy of data collection and reimbursement processes. M84.352 provides a clear distinction from other fracture types, which aids in clinical management and research.

Reimbursement & Billing Impact

reimbursement processes. M84.352 provides a clear distinction from other fracture types, which aids in clinical management and research.

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 is the difference between a stress fracture and an acute fracture?

A stress fracture is a small crack in the bone caused by repetitive stress, while an acute fracture is a complete break in the bone typically resulting from a single traumatic event.