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ICD-10 Guide
ICD-10 CodesM84.445

M84.445

Billable

Pathological fracture, left finger(s)

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

Code Description

ICD-10 M84.445 is a billable code used to indicate a diagnosis of pathological fracture, left finger(s).

Key Diagnostic Point:

A pathological fracture of the left finger(s) occurs when a bone in the finger breaks due to an underlying disease process rather than from a traumatic injury. This type of fracture is often associated with conditions that weaken bone structure, such as osteoporosis, osteogenesis imperfecta, or metastatic bone disease. In patients with osteoporosis, the bone density is significantly reduced, making bones more susceptible to fractures even with minimal or no trauma. The left finger(s) may be affected by various factors, including age, hormonal changes, nutritional deficiencies, and certain medications that impact bone metabolism. Diagnosis typically involves imaging studies such as X-rays or MRIs to confirm the fracture and assess the extent of bone loss. Treatment may include pain management, immobilization, 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 the underlying conditions contributing to bone density loss
  • Accurate documentation of the specific location of the fracture
  • Knowledge of associated codes for osteoporosis or other bone disorders

Audit Risk Factors

  • Inadequate documentation of the underlying bone disorder
  • Failure to specify the exact location of the fracture
  • Misclassification of a traumatic fracture as pathological
  • Lack of supporting imaging reports

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the fracture type, location, and any imaging studies performed.

Common Clinical Scenarios

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

Billing Considerations

Ensure that the underlying conditions affecting bone density are documented.

Endocrinology

Documentation Requirements

Documentation of bone density tests and management of osteoporosis or other metabolic bone diseases.

Common Clinical Scenarios

Patients with osteoporosis experiencing fractures.

Billing Considerations

Linking the fracture to the underlying metabolic disorder is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use M84.445 When
  • According to ICD
  • 10 guidelines, M84
  • 445 should be used when a fracture occurs due to an underlying disease process
  • Coders must ensure that the underlying condition is documented and coded appropriately

Exclusion Criteria

Do NOT use M84.445 When
  • Exclusion criteria include fractures resulting from trauma

Related ICD-10 Codes

Related CPT Codes

20605CPT Code

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

Clinical Scenario

Used when treating joint effusion related to a fracture.

Documentation Requirements

Document the reason for the procedure and any imaging studies.

Specialty Considerations

Orthopedic specialists should ensure proper linkage to the fracture diagnosis.

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 like osteoporosis and other bone density disorders. 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 like osteoporosis and other bone density disorders. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

reimbursement and compliance with payer requirements.

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.