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ICD-10 Guide
ICD-10 CodesM84.375

M84.375

Billable

Stress fracture, left foot

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

Code Description

ICD-10 M84.375 is a billable code used to indicate a diagnosis of stress fracture, left foot.

Key Diagnostic Point:

A stress fracture in the left foot is a small crack in one of the bones of the foot, typically resulting from repetitive force or overuse rather than a single traumatic event. This condition is often seen in athletes or individuals who engage in high-impact activities. Stress fractures can occur in various bones of the foot, including the metatarsals, tarsals, and calcaneus. The underlying cause often relates to bone density disorders, such as osteoporosis, where the bones become weak and brittle, increasing the risk of fractures. In patients with osteoporosis, even minor stress can lead to fractures due to compromised bone strength. Diagnosis is typically made through clinical evaluation and imaging studies, such as X-rays or MRI, which can reveal the fracture and assess the surrounding bone density. Treatment usually involves rest, modification of activities, and possibly the use of supportive footwear or orthotics. In severe cases, surgical intervention may be necessary to stabilize the fracture. Monitoring bone health and density is crucial in preventing future fractures, especially in populations at risk for osteoporosis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between stress fractures and other types of fractures
  • Understanding the relationship between osteoporosis and stress fractures
  • Need for precise documentation of the location and severity of the fracture
  • Potential for co-existing conditions affecting bone density

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document pre-existing bone density disorders
  • Misclassification of the fracture type
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes on the patient's history, physical examination findings, imaging results, and treatment plan.

Common Clinical Scenarios

Athletes presenting with foot pain after increased training intensity, elderly patients with falls leading to foot pain.

Billing Considerations

Consideration of the patient's overall bone health and any history of osteoporosis or other metabolic bone diseases.

Endocrinology

Documentation Requirements

Assessment of bone density through DEXA scans, documentation of any hormonal imbalances affecting bone metabolism.

Common Clinical Scenarios

Patients with osteoporosis presenting with fractures, individuals with endocrine disorders affecting bone health.

Billing Considerations

Monitoring and managing underlying conditions that may contribute to decreased bone density.

Coding Guidelines

Inclusion Criteria

Use M84.375 When
  • According to ICD
  • 10 guidelines, M84
  • 375 should be used when a stress fracture is confirmed in the left foot
  • It is important to document the specific bone involved and any relevant history of osteoporosis or other bone density disorders

Exclusion Criteria

Do NOT use M84.375 When
  • Exclusion criteria include acute fractures and fractures due to trauma

Related ICD-10 Codes

Related CPT Codes

73630CPT Code

Radiologic examination, foot; complete, minimum of 3 views

Clinical Scenario

Used to confirm the diagnosis of a stress fracture in the left foot.

Documentation Requirements

Radiology report must indicate the presence of a stress fracture.

Specialty Considerations

Orthopedic specialists should ensure imaging is comprehensive to assess for other potential injuries.

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 conditions effectively. The granularity of ICD-10 codes helps in understanding the prevalence of stress fractures in different populations, particularly those with osteoporosis.

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 conditions effectively. The granularity of ICD-10 codes helps in understanding the prevalence of stress fractures in different populations, particularly those with osteoporosis.

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 conditions effectively. The granularity of ICD-10 codes helps in understanding the prevalence of stress fractures in different populations, particularly those with osteoporosis.

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 a regular fracture?

A stress fracture is a small crack in the bone caused by repetitive force or overuse, while a regular fracture typically results from a single traumatic event. Stress fractures often occur in weight-bearing bones and are more common in athletes and individuals with low bone density.