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v1.0.0
ICD-10 Guide
ICD-10 CodesM84.379

M84.379

Billable

Stress fracture, unspecified toe(s)

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

Code Description

ICD-10 M84.379 is a billable code used to indicate a diagnosis of stress fracture, unspecified toe(s).

Key Diagnostic Point:

A stress fracture in the toe(s) is a small crack in the bone that occurs due to 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 result from various factors, including inadequate bone density, which is commonly associated with osteoporosis, a condition characterized by weakened bones that are more susceptible to fractures. In the case of stress fractures in the toes, symptoms may include localized pain, swelling, and tenderness, particularly during weight-bearing activities. Diagnosis typically involves a thorough clinical evaluation, including a physical examination and imaging studies such as X-rays or MRI to confirm the presence of a fracture. Treatment often involves rest, ice, and possibly immobilization of the affected toe(s) to promote healing. Understanding the underlying bone metabolism and density disorders is crucial, as these factors can significantly influence the risk of stress fractures. Proper management and preventive strategies are essential to reduce the incidence of stress fractures, especially in populations at risk for osteoporosis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for imaging studies to confirm diagnosis
  • Differentiation from other types of fractures
  • Potential for co-existing conditions affecting bone density

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the affected toe(s)
  • Lack of imaging results in the medical record
  • Misclassification of the fracture type

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Athletes presenting with toe pain after increased training intensity, patients with a history of osteoporosis experiencing foot pain.

Billing Considerations

Ensure clear documentation of the specific toe affected and any contributing factors such as bone density issues.

Endocrinology

Documentation Requirements

Assessment of bone density, history of osteoporosis, and management of underlying metabolic bone disorders.

Common Clinical Scenarios

Patients with osteoporosis presenting with stress fractures, evaluation of bone health in postmenopausal women.

Billing Considerations

Document any treatments for osteoporosis that may impact fracture risk.

Coding Guidelines

Inclusion Criteria

Use M84.379 When
  • Follow the official ICD
  • CM guidelines for coding fractures, ensuring to document the specific location and type of fracture
  • Include any relevant history of osteoporosis or other bone density disorders

Exclusion Criteria

Do NOT use M84.379 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 in the toe.

Documentation Requirements

Include imaging results and clinical findings.

Specialty Considerations

Orthopedic specialists should ensure imaging is appropriate for the suspected fracture.

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. M84.379 provides a clear designation for unspecified toe stress fractures, aiding in better patient care and resource allocation.

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. M84.379 provides a clear designation for unspecified toe stress fractures, aiding in better patient care and resource allocation.

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. M84.379 provides a clear designation for unspecified toe stress fractures, aiding in better patient care and resource allocation.

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 toes?

Common causes include repetitive activities such as running, jumping, or dancing, as well as underlying conditions like osteoporosis that weaken bone structure.

How can stress fractures in the toes be prevented?

Prevention strategies include proper footwear, gradual increases in activity intensity, and addressing any underlying bone density issues through medical management.