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v1.0.0
ICD-10 Guide
ICD-10 CodesM84.672

M84.672

Billable

Pathological fracture in other disease, left ankle

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

Code Description

ICD-10 M84.672 is a billable code used to indicate a diagnosis of pathological fracture in other disease, left ankle.

Key Diagnostic Point:

A pathological fracture in the left ankle occurs when a 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, osteogenesis imperfecta, or metastatic bone disease. In patients with osteoporosis, for instance, the bones become porous and brittle, leading to an increased risk of fractures even with minimal or no trauma. The left ankle, being a weight-bearing joint, is particularly susceptible to such fractures. Diagnosis typically involves imaging studies like X-rays or MRIs to confirm the fracture and assess the underlying bone condition. Treatment may include immobilization, pain management, and addressing the underlying disease to improve bone health. Understanding the patient's medical history, including any chronic conditions that may contribute to bone fragility, is crucial for accurate coding and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of underlying diseases affecting bone health.
  • Differentiation from traumatic fractures.
  • Need for comprehensive patient history.
  • Potential for multiple co-morbidities.

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 studies to support the diagnosis.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, patient history, and treatment plans.

Common Clinical Scenarios

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

Billing Considerations

Ensure clear documentation of the fracture type and underlying conditions.

Endocrinology

Documentation Requirements

Thorough evaluation of metabolic bone diseases, lab results.

Common Clinical Scenarios

Patients with osteoporosis or other metabolic bone disorders experiencing fractures.

Billing Considerations

Documenting the impact of hormonal imbalances on bone density.

Coding Guidelines

Inclusion Criteria

Use M84.672 When
  • According to ICD
  • 10 guidelines, M84
  • 672 should be used when a fracture occurs due to an underlying disease process
  • Coders must ensure that the underlying condition is well
  • documented and that the fracture is not due to trauma
  • Inclusion criteria include fractures resulting from osteoporosis or other metabolic bone diseases

Exclusion Criteria

Do NOT use M84.672 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 joint involved.

Specialty Considerations

Orthopedic specialists should ensure accurate documentation of the fracture type.

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 track and manage conditions like osteoporosis and other bone diseases. This specificity aids in better patient care and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of pathological fractures, improving the ability to track and manage conditions like osteoporosis and other bone diseases. This specificity aids in better patient care and resource allocation.

Reimbursement & Billing Impact

reimbursement and quality care.

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.