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v1.0.0
ICD-10 Guide
ICD-10 CodesM84.673

M84.673

Billable

Pathological fracture in other disease, unspecified ankle

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

Code Description

ICD-10 M84.673 is a billable code used to indicate a diagnosis of pathological fracture in other disease, unspecified ankle.

Key Diagnostic Point:

A pathological fracture in the ankle occurs when the bone breaks due to an underlying disease rather than from a direct trauma or injury. This type of fracture is often associated with conditions that affect bone density and metabolism, such as osteoporosis, osteomalacia, or metastatic bone disease. In patients with osteoporosis, for instance, the bones become porous and brittle, leading to an increased risk of fractures even with minimal or no trauma. The ankle is a common site for such fractures due to its weight-bearing function and the stress it endures during daily activities. Diagnosis typically involves imaging studies, such as X-rays or MRIs, to confirm the fracture and assess the underlying bone condition. Treatment may include pain management, immobilization of the ankle, and addressing the underlying disease to improve bone health. Understanding the nuances of this code is essential for accurate documentation and billing, as it reflects the complexity of managing patients with compromised bone health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of underlying diseases affecting bone health.
  • Differentiation from traumatic fractures.
  • Need for precise documentation of the underlying condition.
  • Potential for multiple co-existing conditions.

Audit Risk Factors

  • Inadequate documentation of the underlying disease.
  • Failure to specify the location of the fracture.
  • Misclassification as a traumatic fracture.
  • Lack of supporting imaging documentation.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on fracture type, location, and underlying conditions.

Common Clinical Scenarios

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

Billing Considerations

Ensure imaging results are included in documentation.

Endocrinology

Documentation Requirements

Comprehensive assessment of bone density and metabolic disorders.

Common Clinical Scenarios

Patients with osteoporosis or metabolic bone diseases experiencing fractures.

Billing Considerations

Document any treatments for underlying conditions affecting bone health.

Coding Guidelines

Inclusion Criteria

Use M84.673 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the underlying disease is documented clearly
  • The code M84
  • 673 should be used when the specific disease causing the fracture is not specified
  • If the underlying condition is known, it should be coded as well

Exclusion Criteria

Do NOT use M84.673 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

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

Clinical Scenario

Used when managing joint effusion in a patient with a pathological fracture.

Documentation Requirements

Document the reason for the procedure and the patient's history of bone disease.

Specialty Considerations

Orthopedic specialists should ensure thorough documentation of the patient's condition.

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 these cases. M84.673 provides a clear distinction for fractures due to underlying diseases, enhancing data accuracy and patient care.

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 these cases. M84.673 provides a clear distinction for fractures due to underlying diseases, enhancing data accuracy and patient care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of pathological fractures, improving the ability to capture the complexity of these cases. M84.673 provides a clear distinction for fractures due to underlying diseases, enhancing data accuracy and patient 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 an underlying disease that weakens the bone, while a traumatic fracture results from an external force or injury.