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ICD-10 Guide
ICD-10 CodesM84.432

M84.432

Billable

Pathological fracture, left ulna

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

Code Description

ICD-10 M84.432 is a billable code used to indicate a diagnosis of pathological fracture, left ulna.

Key Diagnostic Point:

A pathological fracture of the left ulna occurs when the bone breaks due to an underlying disease process rather than from a traumatic injury. This type of fracture is often associated with conditions such as osteoporosis, osteogenesis imperfecta, or metastatic bone disease, where the structural integrity of the bone is compromised. In patients with osteoporosis, decreased bone density leads to increased fragility, making bones more susceptible to fractures even with minimal or no trauma. The ulna, one of the two long bones in the forearm, can be particularly vulnerable in individuals with these conditions. Diagnosis typically involves imaging studies such as X-rays or CT scans, which reveal the fracture and any associated bone density issues. Treatment may include stabilization of the fracture, pain management, and addressing the underlying bone density disorder through medications like bisphosphonates or calcium and vitamin D supplementation. Understanding the patient's overall bone health is crucial for effective management and prevention of future fractures.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of underlying bone density disorders.
  • Differentiation from traumatic fractures.
  • Need for comprehensive patient history.
  • Potential for multiple co-morbid conditions affecting bone health.

Audit Risk Factors

  • Inadequate documentation of the underlying condition.
  • Failure to specify the type of fracture (e.g., displaced vs. non-displaced).
  • Lack of imaging reports to support the diagnosis.
  • Misclassification of the fracture type.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, surgical notes, and history of bone health.

Common Clinical Scenarios

Patients presenting with fractures after minimal trauma, history of osteoporosis.

Billing Considerations

Ensure accurate documentation of fracture type and underlying conditions.

Endocrinology

Documentation Requirements

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

Common Clinical Scenarios

Patients with known osteoporosis presenting with fractures.

Billing Considerations

Documenting the management of bone density disorders is crucial.

Coding Guidelines

Inclusion Criteria

Use M84.432 When
  • According to ICD
  • 10 coding guidelines, M84
  • 432 should be used when the fracture is confirmed to be pathological
  • Coders must ensure that the underlying condition contributing to the fracture is documented

Exclusion Criteria

Do NOT use M84.432 When
  • Exclusion criteria include traumatic fractures and fractures not related to a pathological process

Related ICD-10 Codes

Related CPT Codes

25600CPT Code

Closed treatment of fracture, ulna

Clinical Scenario

Used when a patient with a pathological fracture undergoes closed reduction.

Documentation Requirements

Surgical notes detailing the procedure and post-operative care.

Specialty Considerations

Orthopedic surgeons should document the rationale for surgical intervention.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of pathological fractures, improving the ability to capture the complexity of bone health issues and their management. This specificity aids in better patient care and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of pathological fractures, improving the ability to capture the complexity of bone health issues and their management. This specificity aids in better patient care and resource allocation.

Reimbursement & Billing Impact

reimbursement and compliance.

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 pathological fracture and a traumatic fracture?

A pathological fracture occurs due to an underlying disease that weakens the bone, while a traumatic fracture results from an external force or injury.