MDS Alert

Reader Questions:

Know These Terms for Stress Fractures

Question: One of the residents in my building was diagnosed with a stress fracture in one ankle. Are there specific ICD-10 codes for stress fractures? Which PDPM clinical category would this fall into?

New Mexico Subscriber

Answer: Stress fractures do have their own ICD-10 code set: M84.3- (Stress fracture). For this resident, report one of the following codes, depending on the specifics, and utilizing a physician query, if necessary:

  • M84.371- (Stress fracture, right ankle)
  • M84.372- (… left ankle)
  • M84.373- (… unspecified ankle).

According to ICD-10, providers might refer to stress fractures by several other terms, including:

  • Fatigue fracture,
  • March fracture,
  • Stress fracture NOS, or
  • Stress reaction.

A resident who has a stress fracture in an ankle would fall into the nonsurgical orthopedic/musculoskeletal clinical category according to the Patient-Driven Payment Model (PDPM).