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M84.412A

✓ Billable

Pathological fracture, left shoulder, initial encounter for fracture

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

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❌ Excludes1

inherited

Rules inherited from parent codes in the hierarchy.

M84.4
  • • collapsed vertebra NEC (M48.5)
  • • pathological fracture in neoplastic disease (M84.5-)
  • • pathological fracture in osteoporosis (M80.-)
  • • pathological fracture in other disease (M84.6-)
  • • stress fracture (M84.3-)
  • • traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)

⚠️ Excludes2

inherited

Rules inherited from parent codes.

M84.4
  • • personal history of (healed) pathological fracture (Z87.311)
M84
  • • traumatic fracture of bone-see fracture, by site

Clinical Description

ICD-10-CM code M84.412A represents pathological fracture, left shoulder, initial encounter for fracture. This code falls under the Diseases of the musculoskeletal system and connective tissue (M00-M99) classification. It is a billable/specific code valid for HIPAA-covered transactions as of October 1, 2025 (FY2026). This code can be used to indicate a diagnosis for reimbursement purposes on insurance claims.

This is a 8-character code at the 7th level of specificity. This is the most specific code available in this subcategory. Coders should note that M84.412A has 6 Excludes1 restriction(s) — codes that cannot be reported together on the same claim.

Frequently Asked Questions

What is ICD-10 code M84.412A?

ICD-10-CM code M84.412A is "Pathological fracture, left shoulder, initial encounter for fracture". It belongs to the category: Diseases of the musculoskeletal system and connective tissue (M00-M99).

Is M84.412A a billable ICD-10 code?

Yes, M84.412A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

What codes are excluded with M84.412A?

M84.412A has 6 Excludes1 rule(s). These codes are mutually exclusive and cannot be coded together on the same claim.

Can M84.412A be coded with other codes?

M84.412A has 2 Excludes2 note(s). These conditions can be coded together if both are documented in the patient record.

Related Codes in M84.412

Other codes in the same category that may be relevant for differential coding:

M84.412DPathological fracture, left shoulder, subsequent encounter for fracture with routine healingM84.412GPathological fracture, left shoulder, subsequent encounter for fracture with delayed healingM84.412KPathological fracture, left shoulder, subsequent encounter for fracture with nonunionM84.412PPathological fracture, left shoulder, subsequent encounter for fracture with malunionM84.412SPathological fracture, left shoulder, sequela

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Code Information

CodeM84.412A
BillableYes
ParentM84.412
CategoryDiseases of the musculoskeletal system and connective tissue (M00-M99)
Excludes16 rule(s)
Excludes22 note(s)

Data Source

CMS ICD-10-CM 2026 Tabular List

Updated October 1, 2025 (FY2026)