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 CodesM84.631

M84.631

Billable

Pathological fracture in other disease, right ulna

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

Code Description

ICD-10 M84.631 is a billable code used to indicate a diagnosis of pathological fracture in other disease, right ulna.

Key Diagnostic Point:

A pathological fracture of the right ulna occurs when the bone breaks due to an underlying disease process rather than from a direct trauma. This type of fracture is often associated with conditions that affect bone density and metabolism, such as osteoporosis, malignancies, or metabolic bone diseases. In patients with osteoporosis, the structural integrity of the bone is compromised, leading to an increased risk of fractures even with minimal or no trauma. The ulna, one of the two long bones in the forearm, can be particularly susceptible to fractures in individuals with weakened bone density. The diagnosis of a pathological fracture typically requires imaging studies, such as X-rays or CT scans, to confirm the fracture and assess the underlying condition. Management may involve treating the underlying disease, pain management, and rehabilitation to restore function. Understanding the etiology of the fracture is crucial for effective treatment and prevention of future fractures.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of underlying diseases affecting bone health.
  • Differentiation from traumatic fractures can be challenging.
  • Documentation must specify the underlying condition causing the fracture.
  • Potential for multiple co-existing conditions complicating coding.

Audit Risk Factors

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

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

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

Billing Considerations

Ensure that the underlying disease is well-documented to support the diagnosis of a pathological fracture.

Endocrinology

Documentation Requirements

Comprehensive evaluation of bone density and metabolic disorders.

Common Clinical Scenarios

Patients with osteoporosis or other metabolic bone diseases experiencing fractures.

Billing Considerations

Documentation should include details on bone density tests and treatment plans for underlying conditions.

Coding Guidelines

Inclusion Criteria

Use M84.631 When
  • According to ICD
  • 10 guidelines, M84
  • 631 should be used when a fracture occurs due to an underlying disease process
  • Coders must ensure that the underlying condition is documented and that the fracture is not due to trauma
  • It is essential to follow the official coding guidelines for specificity and accuracy

Exclusion Criteria

Do NOT use M84.631 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 a patient with a pathological fracture requires joint aspiration.

Documentation Requirements

Document the reason for aspiration and any findings.

Specialty Considerations

Orthopedic specialists may perform this procedure in conjunction with fracture management.

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. M84.631 provides a clear distinction between traumatic and pathological fractures, enhancing data accuracy for epidemiological studies and treatment outcomes.

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. M84.631 provides a clear distinction between traumatic and pathological fractures, enhancing data accuracy for epidemiological studies and treatment outcomes.

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. M84.631 provides a clear distinction between traumatic and pathological fractures, enhancing data accuracy for epidemiological studies and treatment outcomes.

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. Proper documentation of the underlying condition is essential for accurate coding.