M84.629A Pathological fracture in other disease, unspecified humerus, initial encounter for fracture

Billable ICD-10-CM code, FY2026.

Built from M84.629 with 7th character A (initial encounter for fracture).

Applies from M84 Disorder of continuity of bone

Excludes2 (not included here)

• traumatic fracture of bone-see fracture, by site

Applies from M84.6 Pathological fracture in other disease

Excludes1 (never code together)

• pathological fracture in osteoporosis (M80.-)

Code also

• underlying condition

7th character note

• The appropriate 7th character is to be added to each code from subcategory M84.6:

7th character required

• A — initial encounter for fracture
• D — subsequent encounter for fracture with routine healing
• G — subsequent encounter for fracture with delayed healing
• K — subsequent encounter for fracture with nonunion
• P — subsequent encounter for fracture with malunion
• S — sequela

Risk adjustment (HCC)

• RxHCC V08: HCC 87 — Osteoporosis, Vertebral and Pathological Fractures

Medicare Code Edits (MCE v43.1 (April 2026))

• Unspecified code (laterality): Unspecified codes for which a more specific code identifying laterality (right, left, bilateral) exists within the same code family.

Code annotations containing back-references to M84.629A

Back-references to M84.6

• Type 1 Excludes: M84.4 Pathological fracture, not elsewhere classified ("pathological fracture in other disease (M84.6-)")

Nearby codes

• M84.622G Pathological fracture in other disease, left humerus, subsequent encounter for fracture with delayed healing
• M84.622K Pathological fracture in other disease, left humerus, subsequent encounter for fracture with nonunion
• M84.622P Pathological fracture in other disease, left humerus, subsequent encounter for fracture with malunion
• M84.622S Pathological fracture in other disease, left humerus, sequela
• M84.629 Pathological fracture in other disease, unspecified humerus
• M84.629A Pathological fracture in other disease, unspecified humerus, initial encounter for fracture (this code)
• M84.629D Pathological fracture in other disease, unspecified humerus, subsequent encounter for fracture with routine healing
• M84.629G Pathological fracture in other disease, unspecified humerus, subsequent encounter for fracture with delayed healing
• M84.629K Pathological fracture in other disease, unspecified humerus, subsequent encounter for fracture with nonunion
• M84.629P Pathological fracture in other disease, unspecified humerus, subsequent encounter for fracture with malunion
• M84.629S Pathological fracture in other disease, unspecified humerus, sequela