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ICD-10 Guide
ICD-10 CodesM84.373

M84.373

Billable

Stress fracture, unspecified ankle

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

Code Description

ICD-10 M84.373 is a billable code used to indicate a diagnosis of stress fracture, unspecified ankle.

Key Diagnostic Point:

A stress fracture of the ankle 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. Unlike acute fractures, stress fractures develop gradually and may not be immediately apparent on standard X-rays. The ankle is a complex joint comprised of multiple bones, including the tibia, fibula, and talus, which can be affected by various factors such as bone density disorders, osteoporosis, and metabolic bone diseases. Individuals with low bone density are at a higher risk for stress fractures, as their bones are less able to withstand the stresses of physical activity. Symptoms typically include localized pain that worsens with activity and improves with rest, swelling, and tenderness in the affected area. Diagnosis often involves imaging studies, such as MRI or bone scans, which can reveal stress fractures that are not visible on X-rays. Treatment usually involves rest, activity modification, and in some cases, physical therapy to strengthen the surrounding muscles and improve bone health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for imaging studies for accurate diagnosis
  • Differentiation from other types of fractures
  • Potential for co-existing conditions like osteoporosis

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document co-existing conditions like osteoporosis
  • Lack of imaging results in the medical record
  • Misclassification of the fracture type

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed history of the injury, imaging results, and treatment plan.

Common Clinical Scenarios

Athletes presenting with ankle pain after increased training intensity.

Billing Considerations

Ensure documentation reflects the chronic nature of the injury and any underlying bone density issues.

Endocrinology

Documentation Requirements

Assessment of bone density, history of metabolic bone disease, and treatment for 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 M84.373 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the fracture type and location
  • Include any relevant history of osteoporosis or other bone density disorders
  • Use additional codes as necessary to capture co
  • existing conditions

Exclusion Criteria

Do NOT use M84.373 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

73630CPT Code

Radiologic examination, ankle

Clinical Scenario

Used when imaging is required to confirm a stress fracture.

Documentation Requirements

Document the reason for imaging and findings.

Specialty Considerations

Orthopedic specialists should ensure imaging results are included in the patient's record.

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 track and manage these injuries. The granularity of ICD-10 codes helps in understanding the epidemiology of stress fractures and their relationship with bone density disorders.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stress fractures, improving the ability to track and manage these injuries. The granularity of ICD-10 codes helps in understanding the epidemiology of stress fractures and their relationship with bone density disorders.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of stress fractures, improving the ability to track and manage these injuries. The granularity of ICD-10 codes helps in understanding the epidemiology of stress fractures and their relationship with bone density disorders.

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 develops gradually due to repetitive stress on the bone, while an acute fracture occurs suddenly due to trauma or injury. Stress fractures may not be visible on X-rays initially, whereas acute fractures typically show clear breaks in the bone.