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 CodesM84.35

M84.35

Billable

Stress fracture, pelvis and femur

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

Code Description

ICD-10 M84.35 is a billable code used to indicate a diagnosis of stress fracture, pelvis and femur.

Key Diagnostic Point:

A stress fracture of the pelvis and femur is a small crack in the bone that occurs due to repetitive force or overuse, often seen in athletes or individuals with increased physical activity. These fractures are particularly concerning in patients with underlying bone density disorders such as osteoporosis, where the bones are more fragile and susceptible to injury. The pelvis and femur are critical weight-bearing bones, and stress fractures in these areas can lead to significant pain, mobility issues, and complications if not properly diagnosed and treated. Symptoms typically include localized pain that worsens with activity and improves with rest. Diagnosis is often confirmed through imaging studies such as X-rays or MRI, which can reveal the extent of the fracture and any associated bone density issues. Management may involve rest, physical therapy, and in some cases, surgical intervention, particularly if the fracture is severe or does not heal adequately. Understanding the relationship between bone metabolism, density disorders, and stress fractures is crucial for effective treatment and prevention strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between stress fractures and other types of fractures.
  • Identifying underlying conditions such as osteoporosis.
  • Variability in presentation and symptoms among patients.
  • Need for precise documentation of the fracture location and type.

Audit Risk Factors

  • Inadequate documentation of the fracture type and location.
  • Failure to document underlying bone density disorders.
  • Misclassification of stress fractures as acute fractures.
  • Lack of imaging studies to support the diagnosis.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, clinical notes describing the mechanism of injury, and treatment plans.

Common Clinical Scenarios

Athletes presenting with hip or thigh pain, elderly patients with falls, and patients with chronic pain syndromes.

Billing Considerations

Ensure that all relevant imaging studies are documented and that the mechanism of injury is clearly described.

Endocrinology

Documentation Requirements

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

Common Clinical Scenarios

Patients with a history of fractures, those undergoing treatment for osteoporosis, and individuals with hormonal imbalances affecting bone health.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use M84.35 When
  • Follow the official ICD
  • CM guidelines for coding fractures, ensuring to document the specific site and type of fracture
  • Include any relevant history of osteoporosis or other bone density disorders

Exclusion Criteria

Do NOT use M84.35 When
  • Exclude codes for acute fractures unless specified

Related ICD-10 Codes

Related CPT Codes

73630CPT Code

Radiologic examination, pelvis, complete, including hips

Clinical Scenario

Used to confirm the diagnosis of a stress fracture in the pelvis.

Documentation Requirements

Radiology report must be included in the patient's medical record.

Specialty Considerations

Orthopedic specialists should ensure imaging is performed and interpreted correctly.

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, particularly in patients with 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, particularly in patients with osteoporosis and other bone density disorders.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of stress fractures, improving the ability to track and manage these injuries, particularly in patients with osteoporosis and other 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 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 is typically the result of a single traumatic event. Stress fractures often develop gradually and may not be visible on initial X-rays.