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ICD-10 Guide
ICD-10 CodesM84.322

M84.322

Billable

Stress fracture, left humerus

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

Code Description

ICD-10 M84.322 is a billable code used to indicate a diagnosis of stress fracture, left humerus.

Key Diagnostic Point:

A stress fracture of the left humerus is a small crack in the bone that occurs due to repetitive force or overuse, rather than a single traumatic event. This condition is often seen in athletes or individuals who engage in high-impact activities. The humerus, being the long bone of the upper arm, is particularly susceptible to stress fractures when subjected to excessive strain, especially in individuals with compromised bone density. Factors such as osteoporosis, which leads to decreased bone mass and strength, can significantly increase the risk of stress fractures. Symptoms typically include localized pain, swelling, and tenderness in the affected area, which may worsen with activity and improve with rest. Diagnosis is usually confirmed through imaging studies such as X-rays or MRI, which can reveal the fracture line and assess the surrounding bone density. Treatment often involves rest, activity modification, and in some cases, physical therapy to strengthen the surrounding muscles and improve bone health. Understanding the underlying bone metabolism and density disorders is crucial for effective management and prevention of future fractures.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between stress fractures and other types of fractures.
  • Understanding the impact of osteoporosis on fracture risk.
  • Need for precise documentation of the location and nature of the fracture.
  • Variability in treatment protocols based on patient age and activity level.

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury.
  • Failure to document co-existing conditions like osteoporosis.
  • Misclassification of the fracture type.
  • Lack of follow-up documentation regarding treatment and recovery.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the patient's history, mechanism of injury, imaging results, and treatment plan.

Common Clinical Scenarios

Athletes presenting with arm pain after increased training intensity.

Billing Considerations

Consideration of bone density testing results and previous fracture history.

Endocrinology

Documentation Requirements

Assessment of bone density, history of osteoporosis, and management of metabolic bone diseases.

Common Clinical Scenarios

Patients with osteoporosis presenting with fractures or pain.

Billing Considerations

Documentation of any medications affecting bone metabolism, such as bisphosphonates.

Coding Guidelines

Inclusion Criteria

Use M84.322 When
  • According to ICD
  • 10 guidelines, M84
  • 322 should be used when a stress fracture is confirmed in the left humerus
  • It is important to document the specific location and nature of the fracture, as well as any underlying conditions such as osteoporosis

Exclusion Criteria

Do NOT use M84.322 When
  • Exclusion criteria include fractures resulting from trauma or pathological fractures due to malignancy

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 the stress fracture.

Documentation Requirements

Document the reason for aspiration and findings.

Specialty Considerations

Orthopedic specialists may frequently 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 stress fractures, improving the ability to track and manage these injuries, especially in populations at risk for osteoporosis and other bone density disorders.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stress fractures, improving the ability to track and manage these injuries, especially in populations at risk for osteoporosis and other bone density disorders.

Reimbursement & Billing Impact

reimbursement and minimizes audit risks.

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 stress fracture and a regular fracture?

A stress fracture is a small crack in the bone caused by repetitive force or overuse, while a regular fracture typically results from a single traumatic event. Stress fractures often occur in bones that are subjected to high levels of stress, especially in individuals with weakened bone density.