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ICD-10 Guide
ICD-10 CodesM84.377

M84.377

Billable

Stress fracture, right toe(s)

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

Code Description

ICD-10 M84.377 is a billable code used to indicate a diagnosis of stress fracture, right toe(s).

Key Diagnostic Point:

A stress fracture of the right toe(s) 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. This condition is particularly common in the metatarsal bones of the foot, which can be affected by factors such as poor bone density, osteoporosis, and inadequate nutrition. Stress fractures can result from a sudden increase in activity, improper footwear, or biomechanical abnormalities. Symptoms typically include localized pain, swelling, and tenderness in the affected toe(s), which may worsen with activity and improve with rest. Diagnosis is often confirmed through clinical evaluation and imaging studies, such as X-rays or MRI, which can reveal the fracture and assess the surrounding bone density. Management usually involves rest, ice, elevation, and possibly immobilization, with a focus on addressing underlying bone health issues to prevent recurrence.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between stress fractures and other types of fractures
  • Understanding the impact of underlying bone density disorders
  • Documentation of specific toe involvement
  • Variability in clinical presentation and imaging findings

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the exact location of the fracture
  • Lack of evidence for underlying bone density issues
  • Improper coding of associated conditions

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes on the mechanism of injury, imaging results, and treatment plan.

Common Clinical Scenarios

Athletes presenting with foot pain after increased training, patients with osteoporosis experiencing foot pain.

Billing Considerations

Ensure clear documentation of the specific toe(s) affected and any underlying conditions that may contribute to the fracture.

Endocrinology

Documentation Requirements

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

Common Clinical Scenarios

Patients with a history of fractures due to osteoporosis presenting with new foot pain.

Billing Considerations

Document any treatments for osteoporosis that may affect fracture healing.

Coding Guidelines

Inclusion Criteria

Use M84.377 When
  • According to ICD
  • 10 coding guidelines, M84
  • 377 should be used when a stress fracture is confirmed in the right toe(s)
  • It is important to document the specific toe(s) affected and any relevant history of bone density disorders

Exclusion Criteria

Do NOT use M84.377 When
  • Exclusion criteria include fractures due to trauma or pathological fractures unrelated to stress

Related ICD-10 Codes

Related CPT Codes

73630CPT Code

Radiologic examination, foot; complete, minimum of 3 views

Clinical Scenario

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

Documentation Requirements

Include imaging results and clinical findings in the patient's record.

Specialty Considerations

Orthopedic specialists should ensure imaging is appropriate for the suspected diagnosis.

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 conditions. M84.377 provides granularity that aids in understanding the prevalence and management of stress fractures in various populations.

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 conditions. M84.377 provides granularity that aids in understanding the prevalence and management of stress fractures in various populations.

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 conditions. M84.377 provides granularity that aids in understanding the prevalence and management of stress fractures in various populations.

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 require different management strategies focused on rest and rehabilitation.