M84.3 Non-Billable Code

Stress fracture

Chapter Classification

Chapter 13 Diseases of the musculoskeletal system and connective tissue (M00-M99)

Section Detail

M80-M85 Disorders of bone density and structure (M80-M85)

Code Hierarchy

This code is a child of M84.

As a non-billable code, it requires more specific digits to be used on a medical claim.

Coding Guidelines & Notes

excludes1

pathological fracture NOS (M84.4.-)
pathological fracture due to osteoporosis (M80.-)
traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)

excludes2

personal history of (healed) stress (fatigue) fracture (Z87.312)
stress fracture of vertebra (M48.4-)

sevenChrDef

{'char': 'A', 'text': 'initial encounter for fracture'}
{'char': 'D', 'text': 'subsequent encounter for fracture with routine healing'}
{'char': 'G', 'text': 'subsequent encounter for fracture with delayed healing'}
{'char': 'K', 'text': 'subsequent encounter for fracture with nonunion'}
{'char': 'P', 'text': 'subsequent encounter for fracture with malunion'}
{'char': 'S', 'text': 'sequela'}

sevenChrNote

The appropriate 7th character is to be added to each code from subcategory M84.3:

useAdditionalCode

external cause code(s) to identify the cause of the stress fracture

More Specific Diagnosis Codes

This code is not billable as it requires a higher level of specificity. Select a more specific code below.

M84.30 - Stress fracture, unspecified site Billable
M84.31 - Stress fracture, shoulder
M84.32 - Stress fracture, humerus
M84.33 - Stress fracture, ulna and radius
M84.34 - Stress fracture, hand and fingers
M84.35 - Stress fracture, pelvis and femur
M84.36 - Stress fracture, tibia and fibula
M84.37 - Stress fracture, ankle, foot and toes
M84.38 - Stress fracture, other site Billable

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