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v1.0.0
ICD-10 Guide
ICD-10 CodesM84.376

M84.376

Billable

Stress fracture, unspecified foot

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

Code Description

ICD-10 M84.376 is a billable code used to indicate a diagnosis of stress fracture, unspecified foot.

Key Diagnostic Point:

A stress fracture in the foot is a small crack in a bone that occurs due to repetitive force or overuse, often exacerbated by conditions such as osteoporosis or other bone density disorders. These fractures are common in athletes and individuals who engage in high-impact activities. The foot is particularly susceptible due to its complex structure and the weight-bearing nature of its bones. Symptoms typically include localized pain that worsens with activity and improves with rest, swelling, and tenderness upon palpation. Diagnosis is often confirmed through imaging studies, such as X-rays or MRI, which can reveal the fracture line or associated bone edema. Treatment usually involves rest, immobilization, and possibly physical therapy to strengthen the surrounding muscles and improve bone density. In cases where osteoporosis is a contributing factor, addressing the underlying bone metabolism disorder is crucial to prevent future fractures. The unspecified nature of this code indicates that the specific location of the stress fracture within the foot is not documented, which can complicate treatment and management strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified location of the fracture can lead to ambiguity in treatment.
  • Requires understanding of bone density disorders and their implications.
  • Differentiating from other types of fractures can be challenging.
  • Documentation must clearly indicate the cause and nature of the fracture.

Audit Risk Factors

  • Inadequate documentation of the fracture's location.
  • Failure to document underlying conditions like osteoporosis.
  • Lack of imaging studies to support the diagnosis.
  • Improper linkage between diagnosis and treatment provided.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, clinical notes on pain assessment, and treatment plans.

Common Clinical Scenarios

Athletes presenting with foot pain after increased activity, elderly patients with a history of falls.

Billing Considerations

Ensure that all relevant imaging and clinical findings are documented to support the diagnosis.

Endocrinology

Documentation Requirements

Bone density test results, history of osteoporosis or metabolic bone disease.

Common Clinical Scenarios

Patients with osteoporosis presenting with foot pain or fractures.

Billing Considerations

Documenting the relationship between bone metabolism disorders and fracture risk is essential.

Coding Guidelines

Inclusion Criteria

Use M84.376 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant history of osteoporosis or other bone density disorders
  • The unspecified nature of the fracture should be clearly justified in the medical record

Exclusion Criteria

Do NOT use M84.376 When
No specific exclusions found.

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.

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 track and manage these injuries. M84.376 provides a means to capture unspecified stress fractures, though it may lead to challenges in treatment planning.

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. M84.376 provides a means to capture unspecified stress fractures, though it may lead to challenges in treatment planning.

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. M84.376 provides a means to capture unspecified stress fractures, though it may lead to challenges in treatment planning.

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 is typically a complete break due to trauma or injury.