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Code: M84.5
Pathological fracture in neoplastic disease
Code also underlying neoplasm
Parent Code Notes: M84
Excludes2: traumatic fracture of bone-see fracture, by site
Seventh Character Notes

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

Coding Guidelines
Diseases of the musculoskeletal system and connective tissue (M00-M99)
Note: Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
Excludes 2: arthropathic psoriasis (L40.5-)
certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
compartment syndrome (traumatic) (T79.A-)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

lmmom64

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I'm not certified yet, and started the coding course late last year, so just got really going on studying the ICD-10. In the instructions for neoplasm with associated pathological fracture, it says to code for the neoplasm first, followed by M84.5 for pathological fracture. But the example is exactly the opposite. It codes the fracture in neoplastic disease first, then codes for the fracture. The "General Code Set" book does this in a few places-- explains the sequencing one way, and gives an example that is just the opposite. This particular example is in the book on page 43. I finished the course, so I don't know where else to answer this question.
 
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