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ICD-10 Guide
ICD-10 CodesM84.44

M84.44

Billable

Pathological fracture, hand and fingers

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

Code Description

ICD-10 M84.44 is a billable code used to indicate a diagnosis of pathological fracture, hand and fingers.

Key Diagnostic Point:

A pathological fracture of the hand and fingers occurs when a bone breaks in response to a disease process rather than due to trauma. This type of fracture is often associated with conditions that weaken bone density, such as osteoporosis, osteogenesis imperfecta, or metastatic bone disease. In patients with osteoporosis, the bones become porous and brittle, increasing the risk of fractures even with minimal or no trauma. Pathological fractures can occur in any bone but are particularly concerning in the hand and fingers due to their functional importance. Diagnosis typically involves imaging studies such as X-rays or MRIs to confirm the fracture and assess the underlying bone condition. Treatment may include immobilization, pain management, and addressing the underlying bone density disorder to prevent future fractures. Understanding the etiology of the fracture is crucial for effective management and prevention strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between traumatic and pathological fractures
  • Understanding underlying bone density disorders
  • Documentation of the cause of the fracture
  • Variability in treatment approaches based on underlying conditions

Audit Risk Factors

  • Inadequate documentation of the underlying bone disorder
  • Failure to specify the location of the fracture accurately
  • Misclassification of traumatic versus pathological fractures
  • Lack of imaging reports to support the diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, treatment plans, and notes on the patient's bone health.

Common Clinical Scenarios

Patients presenting with fractures after minimal trauma, particularly in older adults.

Billing Considerations

Ensure that the underlying condition contributing to the fracture is well-documented.

Endocrinology

Documentation Requirements

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

Common Clinical Scenarios

Patients with osteoporosis experiencing fractures.

Billing Considerations

Documenting the patient's treatment regimen for bone density disorders.

Coding Guidelines

Inclusion Criteria

Use M84.44 When
  • According to ICD
  • 10 guidelines, M84
  • 44 should be used when a fracture is confirmed to be pathological, necessitating documentation of the underlying condition

Exclusion Criteria

Do NOT use M84.44 When
  • Exclusion criteria include fractures resulting from trauma or those not related to a metabolic bone disorder

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used when joint aspiration is needed due to swelling from a fracture.

Documentation Requirements

Document the reason for aspiration and findings.

Specialty Considerations

Orthopedic specialists often perform this procedure.

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 track and manage conditions related to bone health. This specificity aids in better patient management 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 track and manage conditions related to bone health. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

reimbursement and quality of care.

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 underlying disease processes that weaken the bone, while a traumatic fracture results from an external force or injury.