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 CodesM84.642

M84.642

Billable

Pathological fracture in other disease, left hand

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

Code Description

ICD-10 M84.642 is a billable code used to indicate a diagnosis of pathological fracture in other disease, left hand.

Key Diagnostic Point:

M84.642 refers to a pathological fracture occurring in the left hand due to an underlying disease process rather than a traumatic event. Pathological fractures are often associated with conditions that compromise bone integrity, such as osteoporosis, osteogenesis imperfecta, or metastatic bone disease. In patients with osteoporosis, for instance, decreased bone density leads to an increased risk of fractures even with minimal or no trauma. The left hand, being a common site for such fractures, can be affected by various factors including age, hormonal changes, and nutritional deficiencies. The clinical presentation may include pain, swelling, and decreased function of the affected hand. Diagnosis typically involves imaging studies such as X-rays or CT scans to confirm the fracture and assess the underlying bone condition. Management may include pain control, immobilization, and addressing the underlying disease to prevent further fractures. Understanding the etiology of the fracture is crucial for effective treatment and prevention strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of underlying diseases affecting bone health.
  • Differentiation from traumatic fractures.
  • Need for precise documentation of the underlying condition.
  • Potential for multiple co-existing conditions affecting coding.

Audit Risk Factors

  • Inadequate documentation of the underlying disease.
  • Failure to specify the location of the fracture accurately.
  • Misclassification of the fracture type (pathological vs. traumatic).
  • Lack of follow-up documentation on treatment and outcomes.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

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

Billing Considerations

Documentation should include bone density assessments and any relevant imaging studies.

Endocrinology

Documentation Requirements

Records of bone density tests and management of osteoporosis or other metabolic bone diseases.

Common Clinical Scenarios

Patients with osteoporosis experiencing fractures.

Billing Considerations

Ensure that the underlying metabolic condition is clearly documented to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use M84.642 When
  • According to ICD
  • 10 coding guidelines, M84
  • 642 should be used when a fracture is due to an underlying disease process
  • Coders must ensure that the underlying condition is documented and that the fracture is not due to a traumatic event
  • It is important to follow the guidelines for specificity and to use additional codes for any co
  • existing conditions

Exclusion Criteria

Do NOT use M84.642 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 the procedure and the findings.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is justified based on the patient's condition.

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, enabling better tracking of conditions like osteoporosis and their complications. M84.642 provides a clear framework for documenting fractures due to underlying diseases, improving patient care and research outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of pathological fractures, enabling better tracking of conditions like osteoporosis and their complications. M84.642 provides a clear framework for documenting fractures due to underlying diseases, improving patient care and research outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of pathological fractures, enabling better tracking of conditions like osteoporosis and their complications. M84.642 provides a clear framework for documenting fractures due to underlying diseases, improving patient care and research 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.