2025 ICD-10-CM code M84.68XK
(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
This code signifies a subsequent encounter for a pathological fracture at a site other than those specified elsewhere, where the fracture has not healed (nonunion).
Medical necessity is established by the presence of a documented pathologic fracture with nonunion, requiring further medical intervention.The underlying disease necessitating this condition must be clearly documented.
The clinical responsibility includes diagnosing the nonunion through patient history, physical examination (assessing range of motion, muscle strength), and imaging studies (X-rays, MRI, CT scans). Treatment might involve analgesics, bracing/splinting, nutritional supplements, physical therapy, treatment of the underlying disease, and possibly surgery.
- Diseases of the musculoskeletal system and connective tissue (M00-M99)
- M84.68XK falls under the broader category of M84 (Osteopathies and chondropathies) and specifically addresses pathological fractures at unspecified sites with nonunion during subsequent encounters.
In simple words: This code is for a follow-up visit to the doctor for a broken bone caused by a disease that weakened the bone, and the bone hasn't healed correctly.
M84.68XK, within the ICD-10-CM coding system, denotes a subsequent encounter for a pathological fracture located at any site not otherwise specified.A pathological fracture is a bone fracture that occurs due to a pre-existing disease process that weakens the bone's structure. This particular code is used specifically when there's a nonunion, meaning the fractured bone has failed to heal properly after the initial fracture.
Example 1: A 70-year-old woman with osteoporosis suffers a pathologic fracture of her femur. After initial treatment, the fracture shows nonunion at a follow-up appointment.M84.68XK is coded for this subsequent encounter., A 55-year-old man with metastatic bone cancer experiences a pathologic fracture in his humerus. Despite treatment, the fracture fails to heal completely.This subsequent visit warrants M84.68XK., A patient with Paget's disease develops a pathological fracture in a rib. During a subsequent visit, it is determined that nonunion is present. Therefore, the provider codes M84.68XK.
Detailed patient history outlining the initial fracture, treatment rendered, and imaging evidence demonstrating nonunion.Documentation of the underlying disease leading to the pathological fracture is crucial.Notes from physical examinations evaluating range of motion and muscle strength should be included.
** Consider using additional codes to specify the underlying disease responsible for the pathological fracture.
- Payment Status: Active
- Specialties:Orthopedics, Oncology, Rheumatology
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient