ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesM84.47

M84.47

Billable

Pathological fracture, ankle, foot and toes

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

Code Description

ICD-10 M84.47 is a billable code used to indicate a diagnosis of pathological fracture, ankle, foot and toes.

Key Diagnostic Point:

A pathological fracture of the ankle, foot, or toes occurs when a bone breaks due to an underlying condition that weakens the bone structure, rather than from a traumatic injury. This can be attributed to various bone density disorders, including osteoporosis, osteomalacia, or metastatic bone disease. In patients with osteoporosis, the bone density is significantly reduced, leading to increased fragility and susceptibility to fractures even with minimal or no trauma. The ankle, foot, and toes are common sites for these fractures due to their weight-bearing function and the stress they endure during daily activities. Diagnosis typically involves imaging studies such as X-rays or MRIs to confirm the fracture and assess the extent of bone density loss. Management may include pain control, immobilization, and addressing the underlying bone metabolism disorder to prevent future fractures. Understanding the etiology of the fracture is crucial for effective treatment and prevention strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between traumatic and pathological fractures
  • Identifying underlying conditions contributing to bone weakness
  • Documenting the specific location and type of fracture
  • Understanding the patient's history of bone density 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 documentation

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, patient history of osteoporosis or other bone disorders, and treatment plans.

Common Clinical Scenarios

Patients presenting with fractures after minimal trauma, elderly patients with a history of falls, and those with chronic conditions affecting bone health.

Billing Considerations

Ensure that the documentation clearly states the cause of the fracture and any relevant comorbidities.

Endocrinology

Documentation Requirements

Bone density test results, history of metabolic bone diseases, and treatment for osteoporosis.

Common Clinical Scenarios

Patients with diagnosed osteoporosis experiencing fractures, and those undergoing treatment for metabolic bone disorders.

Billing Considerations

Document the patient's bone health status and any medications affecting bone density.

Coding Guidelines

Inclusion Criteria

Use M84.47 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture's cause and location
  • Include any relevant history of osteoporosis or other bone density disorders

Exclusion Criteria

Do NOT use M84.47 When
  • Exclude codes for traumatic fractures unless specified

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

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

Clinical Scenario

Used in conjunction with M84.47 for joint pain management post-fracture.

Documentation Requirements

Document the reason for the procedure and the patient's fracture history.

Specialty Considerations

Orthopedic specialists may perform this procedure to alleviate joint swelling.

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 nuances of bone health and related conditions. This specificity aids in better tracking of treatment outcomes and resource allocation for patients with bone density disorders.

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 nuances of bone health and related conditions. This specificity aids in better tracking of treatment outcomes and resource allocation for patients with bone density disorders.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of pathological fractures, improving the ability to capture the nuances of bone health and related conditions. This specificity aids in better tracking of treatment outcomes and resource allocation for patients with bone density disorders.

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 condition that weakens the bone, while a traumatic fracture results from an external force or injury.