M84.479A Pathological fracture, unspecified toe(s), initial encounter for fracture

ICD-10-CM M84.479A: Pathological fracture, unspecified toe(s), initial encounter for fracture

ICD-10-CM code M84.479A identifies a pathological fracture of unspecified toe(s) during an initial encounter for the fracture. The concept is an active diagnosis classified as a pathologic function. It appears in official terminology records and payer or laboratory coverage documents, which list it alongside related subsequent encounter or other site codes. 1 2 3

Plain-language overview

Code M84.479A represents a diagnosis of a pathological fracture in unspecified toe(s) and applies to the initial encounter for that fracture, serving as an active terminology concept. 1

What this code represents

The official display label for M84.479A is Pathological fracture, unspecified toe(s), initial encounter for fracture, and the concept has the semantic type of Pathologic Function. 1

Coding details

M84.479A is a child concept of M84.479, Pathological fracture, unspecified toe(s), and the terminology record indicates that M84.479A has narrower concepts within the ICD-10-CM version 2026. 1

An official published abbreviation for M84.479A is Pathological fracture, unsp toe(s), init encntr for fracture, matching the full preferred name for the initial encounter. 1

Documentation considerations

The code designation specifies an initial encounter for fracture, and coders can distinguish it from M84.479D, which represents a subsequent encounter for the same unspecified toe pathological fracture. 2

Coverage and utilization context

M84.479A appears in a Medicare billing and coding article for musculoskeletal indications, listing the code alongside M84.479D without stating that inclusion guarantees coverage for any service. 2

A laboratory coverage policy for collagen crosslinks testing includes M84.479A in a code list, placing it adjacent to M84.48XA for pathological fracture of another site during an initial encounter. 3

What the sources add

The official terminology record establishes the code's active status, parent concept, and semantic type, while coverage documents show its operational appearance in payer and laboratory policy code lists. 1 2 3

Comparing the sources, the terminology record defines the code's hierarchical structure, whereas the Medicare article and laboratory policy demonstrate its use alongside related encounter or site distinction codes. 1 2 3

Sources

1. ICD-10-CM M84.479A terminology record — National Cancer Institute Enterprise Vocabulary Services; accessed 2026-07-27.
2. Article - Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (A59764) — cms.gov; accessed 2026-07-27.
3. 190.19 - Collagen Crosslinks, Any Method — hnl.com; accessed 2026-07-27.