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v1.0.0
ICD-10 Guide
ICD-10 CodesM84.443

M84.443

Billable

Pathological fracture, unspecified hand

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

Code Description

ICD-10 M84.443 is a billable code used to indicate a diagnosis of pathological fracture, unspecified hand.

Key Diagnostic Point:

A pathological fracture of the hand occurs when a bone breaks in response to a disease process rather than due to trauma. This type of fracture is often associated with conditions that weaken bone density, such as osteoporosis, osteogenesis imperfecta, or metastatic cancer. In the case of M84.443, the fracture is unspecified, meaning that the exact location within the hand is not detailed. Osteoporosis, a common bone density disorder, significantly increases the risk of such fractures, particularly in older adults, as the bones become porous and brittle. The hand consists of multiple bones, including the phalanges and metacarpals, and fractures can lead to pain, swelling, and impaired function. Diagnosis typically involves imaging studies such as X-rays, which can reveal the fracture and assess the surrounding bone density. Treatment may include immobilization, pain management, and addressing the underlying bone density disorder to prevent future fractures. Understanding the relationship between bone metabolism and fracture risk is crucial for effective management and prevention strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified nature of the fracture complicates documentation.
  • Requires understanding of underlying conditions affecting bone density.
  • Potential for multiple fracture sites within the hand.
  • Need for accurate assessment of bone health and related disorders.

Audit Risk Factors

  • Inadequate documentation of the underlying condition leading to the fracture.
  • Failure to specify the exact location of the fracture.
  • Lack of imaging reports to support the diagnosis.
  • Inconsistent coding of related conditions such as osteoporosis.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, clinical notes on fracture assessment, and treatment plans.

Common Clinical Scenarios

Patients presenting with fractures after minimal trauma, particularly in older adults.

Billing Considerations

Documentation must clearly outline the mechanism of injury and any underlying bone density issues.

Endocrinology

Documentation Requirements

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

Common Clinical Scenarios

Patients with known osteoporosis presenting with fractures.

Billing Considerations

Focus on the management of bone health and prevention of future fractures.

Coding Guidelines

Inclusion Criteria

Use M84.443 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the code reflects the clinical documentation accurately
  • Include any relevant underlying conditions that contribute to the fracture

Exclusion Criteria

Do NOT use M84.443 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

73030CPT Code

Radiologic examination, hand

Clinical Scenario

Used when imaging is performed to assess the fracture.

Documentation Requirements

Radiology report detailing findings.

Specialty Considerations

Orthopedic specialists should ensure imaging correlates with clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fractures, improving the ability to capture the nuances of pathological fractures and their underlying causes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the ability to capture the nuances of pathological fractures and their underlying causes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, improving the ability to capture the nuances of pathological fractures and their underlying causes.

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