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 CodesM84.641

M84.641

Billable

Pathological fracture in other disease, right hand

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

Code Description

ICD-10 M84.641 is a billable code used to indicate a diagnosis of pathological fracture in other disease, right hand.

Key Diagnostic Point:

M84.641 refers to a pathological fracture occurring in the right hand due to underlying diseases affecting bone density and metabolism, such as osteoporosis, osteogenesis imperfecta, or metastatic bone disease. These fractures are not the result of trauma but rather occur due to weakened bone structure from these conditions. Osteoporosis, characterized by reduced bone mass and deterioration of bone tissue, significantly increases the risk of fractures, particularly in the elderly population. Pathological fractures can occur in various locations, but in this case, the focus is on the right hand, which may involve the metacarpals or phalanges. Diagnosis typically involves imaging studies such as X-rays or MRIs to confirm the fracture and assess the underlying bone condition. Treatment may include stabilization of the fracture, pain management, and addressing the underlying disease to improve bone health and prevent future fractures. Understanding the relationship between bone metabolism disorders and fracture risk is crucial for effective management and coding of these conditions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of underlying diseases affecting bone density.
  • Differentiation from traumatic fractures.
  • Documentation must specify the location and nature of the fracture.
  • Need for comprehensive patient history to identify underlying conditions.

Audit Risk Factors

  • Inadequate documentation of the underlying disease.
  • Failure to specify the exact location of the fracture.
  • Misclassification as a traumatic fracture.
  • Lack of imaging reports to support the diagnosis.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, fracture location, and underlying disease documentation.

Common Clinical Scenarios

Patients with osteoporosis presenting with wrist fractures.

Billing Considerations

Ensure that the fracture is documented as pathological and not traumatic.

Endocrinology

Documentation Requirements

Comprehensive evaluation of bone density and metabolic disorders.

Common Clinical Scenarios

Patients with metabolic bone diseases presenting with fractures.

Billing Considerations

Documenting the relationship between metabolic disorders and fracture risk.

Coding Guidelines

Inclusion Criteria

Use M84.641 When
  • According to ICD
  • 10 guidelines, M84
  • 641 should be used when a fracture is due to an underlying disease affecting bone density
  • Documentation must clearly indicate the nature of the fracture and the underlying condition

Exclusion Criteria

Do NOT use M84.641 When
  • Exclusion criteria include fractures resulting from trauma or accidents

Related ICD-10 Codes

Related CPT Codes

20670CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used for joint injections in patients with fractures.

Documentation Requirements

Document the joint involved and the reason for the procedure.

Specialty Considerations

Orthopedic specialists often 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 pathological fractures, improving the ability to capture the complexity of these cases and the underlying conditions affecting bone health.

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 and the underlying conditions affecting bone health.

Reimbursement & Billing Impact

reimbursement and reduces the risk of audits.

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 underlying diseases that weaken the bone, while a traumatic fracture results from an external force or injury.