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2025 ICD-10-CM code M84.3

Stress fracture

Use an external cause code (e.g., W50-Y33 for Activities involving other sports and recreational activities) following the code for the stress fracture to identify the cause, if applicable.

Use the appropriate 7th character to indicate the encounter type (initial, subsequent, sequela).

Medical necessity for treatment of a stress fracture is established by the presence of signs and symptoms, such as pain, tenderness, and/or swelling, impacting the patient's ability to perform daily activities or participate in sports. Imaging studies confirming the diagnosis further support medical necessity.

Physicians diagnose stress fractures based on patient history, physical exam, and imaging studies (X-ray, MRI, bone scan). Treatment involves activity modification, rest, ice, compression, elevation, immobilization (splint or cast), pain medication (NSAIDs), and surgery for severe cases.

In simple words: A stress fracture is a tiny crack in a bone, often caused by doing too much of an activity, like running or jumping, without enough rest. It's common in athletes. It hurts more when you're active and feels better with rest.Doctors usually recommend rest, avoiding the activity that caused it, and sometimes wearing a special boot or using crutches.If it's a bad stress fracture or doesn't heal, you might need surgery.

A stress fracture is a small crack in a bone caused by overuse and repetitive activity. It's common in athletes and military recruits, particularly in the lower extremities.Symptoms include localized pain worsening with activity, tenderness, and sometimes swelling. Diagnosis typically involves physical examination, X-rays, and potentially MRI or bone scan if initial X-rays are negative. Treatment usually consists of rest, activity modification, pain relief, and possibly immobilization.In some cases, surgery may be necessary for high-risk fractures or nonunion.

Example 1: A marathon runner develops pain in their shin that worsens with running and improves with rest. An X-ray reveals a stress fracture in the tibia., A basketball player experiences increasing foot pain during practice. An MRI confirms a navicular stress fracture., A military recruit develops persistent thigh pain after intense training. A bone scan reveals a femoral shaft stress fracture.

Documentation should include details of the patient's activity level, onset and nature of pain, physical exam findings (tenderness, swelling, range of motion), imaging results, and treatment plan.

** Stress fractures are often misdiagnosed as shin splints or other conditions. Early diagnosis and treatment are essential to prevent progression to a complete fracture.

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