2025 ICD-10-CM code M84.359G
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Musculoskeletal - Osteopathies and chondropathies Diseases of the musculoskeletal system and connective tissue (M00-M99) Feed
Stress fracture of the hip, unspecified, subsequent encounter for fracture with delayed healing.
Medical necessity is established by the presence of a documented stress fracture of the hip with delayed union or nonunion, confirmed by appropriate imaging and clinical examination.The delayed healing indicates the need for further medical intervention and follow-up care.
The clinical responsibility involves diagnosing the delayed healing of the stress fracture through physical examination, review of medical history, laboratory tests (calcium and vitamin D levels), and imaging studies (X-ray, MRI, bone scan). Treatment may include rest, immobilization (splint or cast), NSAIDs for pain relief, and, in severe cases, surgical intervention.
- Diseases of the musculoskeletal system and connective tissue (M00-M99)
- M84.359 (Stress fracture, hip, unspecified) - M84.359G (subsequent encounter for fracture with delayed healing)
In simple words: This code is used for a follow-up visit for a hip stress fracture that's not healing as expected. It means the fracture hasn't healed completely and needs more treatment.
This ICD-10-CM code signifies a subsequent encounter for a patient with a previously diagnosed stress fracture of the hip that is exhibiting delayed healing.The fracture is unspecified regarding its exact location within the hip. The code is utilized when the patient is experiencing a setback in the healing process, requiring further medical attention or intervention.
Example 1: A 35-year-old female marathon runner presents with persistent hip pain and limited range of motion, despite initial treatment for a stress fracture 6 weeks prior. Imaging reveals delayed healing.M84.359G is used to code the subsequent encounter., A 50-year-old male with osteoporosis experiences a stress fracture in his hip.After initial treatment, healing is slow, requiring additional interventions and follow-up visits coded with M84.359G., A 22-year-old basketball player suffers a stress fracture in his hip.Despite the initial treatment, the fracture shows signs of delayed healing during a follow-up visit, requiring additional medical management coded using M84.359G.
Detailed medical history of the injury, including mechanism and onset of symptoms.Findings from physical examination (pain, swelling, tenderness).Imaging reports (X-ray, MRI, bone scan) demonstrating the fracture and delayed healing.Laboratory results (calcium and vitamin D levels).Treatment plan and response to treatment.
** This code is for subsequent encounters only; use M84.359A for the initial encounter.If the delayed healing leads to a complication such as nonunion or malunion, use the appropriate codes (M84.359K or M84.359P) instead.
- Payment Status: Active
- Specialties:Orthopedics, Sports Medicine, Rheumatology
- Place of Service:Office, Hospital Outpatient Department, Urgent Care Facility