ICD-10-CM 2027 diagnosis code
M84.511DPathological fracture in neoplastic disease, right shoulder, subsequent encounter for fracture with routine healing
M84.511D is a valid, billable ICD-10-CM code for pathological fracture in neoplastic disease, right shoulder, subsequent encounter for fracture with routine healing. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.Short description: Path fx in neopltc dis, r shldr, subs for fx w routn heal
Code unchanged since ICD-10-CM took effect on October 1, 2015. Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data
About M84.511D
M84.511D is the ICD-10-CM diagnosis code for pathological fracture in neoplastic disease, right shoulder, subsequent encounter for fracture with routine healing. It belongs to category M84 (disorder of continuity of bone), block M80-M85 (disorders of bone density and structure) and chapter 13 (diseases of the musculoskeletal system and connective tissue). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.
The 7th character "D" means subsequent encounter for fracture with routine healing: use it for encounters after active treatment, while the patient is healing or recovering.
It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.
In MS-DRG v44.0, it is part of the grouping logic for DRG 559 (Aftercare, Musculoskeletal System and Connective Tissue with MCC, relative weight 1.8088), DRG 560 (Aftercare, Musculoskeletal System and Connective Tissue with CC, relative weight 1.1238) and DRG 561 (Aftercare, Musculoskeletal System and Connective Tissue without CC/MCC, relative weight 0.8258), in MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.
It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.
Before ICD-10, this condition was coded in ICD-9-CM as V54.21 (aftercare for healing pathologic fracture of upper arm).
7th character
Dsubsequent encounter for fracture with routine healing
CC/MCC status for this injury by encounter: CC for A, K, P; Neither CC nor MCC for D, G, S.
Other encounter types for M84.511:
Notes that apply from higher levels
Instructions written at a parent level also apply to M84.511D.
› From M84.5 Pathological fracture in neoplastic disease
- underlying neoplasm
› From M84 Disorder of continuity of bone
- traumatic fracture of bone-see fracture, by site
Broader instructions also apply from Chapter 13: Diseases of the musculoskeletal system and connective tissue.
MS-DRG v44.0 grouping
All DRGs →Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.
MDC 08 · Diseases and Disorders of the Musculoskeletal System and Connective Tissue
ICD-9-CM equivalent
Converter →- V54.21Aftercare for healing pathologic fracture of upper armapproximate
From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.
Code history
- 2016
- 2017
- 2018
- 2019
- 2020
- 2021
- 2022
- 2023
- 2024
- 2025
- 2026
- 2027
- FY2016 (effective 10/1/2015): Added (first year of ICD-10-CM)
- No changes since FY2016.
Common questions about M84.511D
Is M84.511D billable?
- Yes. M84.511D is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).
What does the "D" at the end of M84.511D mean?
- It is the 7th character for subsequent encounter for fracture with routine healing. Per the official guidelines, use it for encounters after active treatment, while the patient is healing or recovering.
Can M84.511D be used as a principal diagnosis?
- Yes. The Medicare Code Editor doesn't restrict M84.511D as a principal diagnosis.
Is M84.511D a CC or MCC?
- No. M84.511D is neither a CC nor an MCC under MS-DRG v44.0.
What DRG does M84.511D group to?
- M84.511D is used in the MS-DRG v44.0 logic for MS-DRG 559 (Aftercare, Musculoskeletal System and Connective Tissue with MCC), MS-DRG 560 (Aftercare, Musculoskeletal System and Connective Tissue with CC) and MS-DRG 561 (Aftercare, Musculoskeletal System and Connective Tissue without CC/MCC). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.