2025 ICD-10-CM code M84.359D
Stress fracture of the hip, unspecified, subsequent encounter for fracture with routine healing.
Medical necessity is established by the diagnosis of a stress fracture and the need for ongoing monitoring of the healing process.Subsequent encounters are necessary to ensure proper healing and to address any potential complications.
Diagnosis and treatment of stress fractures of the hip are typically managed by orthopedic specialists or primary care physicians with experience in musculoskeletal injuries.Diagnosis may involve physical examination, imaging studies (X-ray, MRI, bone scan), and laboratory tests. Treatment options include rest, immobilization, pain management, and in some cases, surgery.
- Diseases of the musculoskeletal system and connective tissue (M00-M99)
- Disorders of bone density and structure (M80-M85)
In simple words: A stress fracture of the hip is a small break in the hip bone due to overuse or repeated injury. This code is used for a follow-up visit when the fracture is healing normally.
Stress fracture, hip, unspecified, subsequent encounter for fracture with routine healing.
Example 1: A patient who was previously diagnosed with a stress fracture of the right hip returns for a follow-up appointment. The fracture is healing normally without complications., A patient with a history of a stress fracture in the left hip presents with ongoing pain.Imaging reveals delayed healing, and the physician recommends a change in the treatment plan., A long-distance runner experiences increasing hip pain.After examination and imaging, a stress fracture of the hip is diagnosed. Subsequent encounters for routine healing would use this code.
Documentation should support the diagnosis of a stress fracture of the hip, including the location and laterality of the fracture.The documentation should also indicate that this is a subsequent encounter and that the healing process is routine and without complications. Any other conditions or complications should be coded separately.
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- Payment Status: Active
- Specialties:Orthopedic Surgery, Sports Medicine, Family Medicine, Primary Care
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital (if complications require admission)