Struggling to Code Pathological Fractures: Follow these tips

Basic about Pathological fractures


ICD 1o codes are very specific in nature. So far, we have seen how to code Z codes and followup codes in ICD 10 which are not easy to search in diagnosis codebook. But, today we will try to learn about coding pathological fractures. Fractures occurring in bones that are weakened by disease are basically termed as pathological fracture. These fractures are generally spontaneous but mostly occur in connection with some minor injury or trauma. Small injury or minor fall that ordinarily do not cause any fracture in normal healthy bones, comes under category of pathological fracture. There is a list of disease which can cause pathological fracture which includes osteoporosis, metastatic tumor of bones, osteomyelitis, hyperparathyroidism and nutritional disorders. We have learn previously about ICD 10 coding degenerative disc disease, lumbar spondylosis, chest pain etc. Let us explore more about coding ICD 10 code for Pathological fracture. Pathological fracture can also be termed as Non-traumatic fractures.


Struggling to Code Pathological Fractures: Follow these tips

Read also: Coding tips for ICD 10 codes

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ICD 10 coding tips for Pathological fracture


Spontaneous fractures are always pathological fractures. Whenever a patient has any fracture, the medical record should be reviewed thoroughly to determine whether any significant trauma is documented or not. If the injury or trauma is minor or not significant to cause fracture, then it should be coded as pathological fracture. A motor vehicle accident, a fall from a height etc. such injuries can be considered to code a traumatic fracture. In pathological fracture patient also suffers from an underlying disease like osteoporosis that caused such fracture. In ICD 10 we have separate categories as well for coding osteoporosis with current osteoporosis fracture.

ICD 10 code category and Subcategory for Pathological fractures

 Their are only few category and subcategory which are used for coding Pathological fractures. We have combined ICD 10 codes for Osteoporosis and neoplasm with pathological fractures. Hence, we should be careful while coding pathological fracture with disease underlying these ICD 10 codes. Below are the ICD 10 codes used for coding pathological fracture.

M80- Osteoporosis with current Pathological fracture
M84.4- Pathological fracture, not elsewhere classified
M84.5- Pathological fracture in neoplastic disease (code also the underlying cause)
M84.6 – pathological fracture in other disease (code also the underlying condition)

Below reference will help to know more about this topic.

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