2025 ICD-10-CM code M84.68XG
Pathological fracture in other disease, other site, subsequent encounter for fracture with delayed healing.
Medical necessity for using M84.68XG is established by the presence of a pathological fracture in a site other than those specifically listed in the ICD-10-CM, with documented delayed healing due to an underlying disease.The underlying disease should also be coded.
Diagnosis involves patient history, physical exam (range of motion, muscle strength), imaging (X-ray, MRI, CT, DXA scan), and lab tests (ESR). Treatment may include pain medication, bracing/splinting, calcium supplements, lifestyle changes, physical therapy, treating the underlying disease, or surgery.
- Diseases of the musculoskeletal system and connective tissue (M00-M99)
- M84.6: Pathological fracture in other disease, other siteM84: Pathological fracture in other diseaseM80-M94: Osteopathies and chondropathiesM00-M99: Diseases of the musculoskeletal system and connective tissue
In simple words: This code describes a follow-up visit for a broken bone that happened because of another medical problem, not an injury.The break is located in an area other than those specifically listed elsewhere, and it is not healing as quickly as it should.
A pathological fracture occurs when a bone breaks in an area that has been weakened by a disease process, distinguishing it from a fracture caused by trauma.This specific code (M84.68XG) signifies a subsequent encounter for a pathological fracture at a site not otherwise specified within the M84.6 range, and the fracture is healing slower than expected (delayed healing). It is crucial to also code the underlying disease that caused the bone weakening.
Example 1: A patient with bone cancer has a follow-up appointment for a pathological fracture in their rib. The fracture is showing signs of delayed healing., A patient with Paget's disease of bone has a follow-up for a pathological fracture in their pelvis. The healing process is slower than expected., A patient with multiple myeloma has a follow-up visit for a pathological fracture in their clavicle.The fracture is healing slowly.
Documentation should include the underlying disease causing the fracture, the location of the fracture, evidence of delayed healing (e.g., imaging reports, clinical findings), and treatment provided.
- Specialties:Orthopedics, Oncology, Endocrinology, Internal Medicine
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital