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M84.359 ICD-10-CM Code: Stress fracture, hip, unspecified

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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Disorders of bone density and structure (M80-M85)

M84.359

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Stress fracture, hip, unspecified

Stress fracture, hip, unspecified

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

Basket needed

Code Book Path

Official
M84.3Stress fracture
M84.35Stress fracture, pelvis and femur
M84.359Stress fracture, hip, unspecified

Inclusion Terms

Official
  • Stress fracture, hip

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M84.359 in this effective period.

Related Child Codes

Official
M84.359AStress fracture, hip, unspecified, initial encounter for fracture
M84.359DStress fracture, hip, unspecified, subsequent encounter for fracture with routine healing
M84.359GStress fracture, hip, unspecified, subsequent encounter for fracture with delayed healing
M84.359KStress fracture, hip, unspecified, subsequent encounter for fracture with nonunion
M84.359PStress fracture, hip, unspecified, subsequent encounter for fracture with malunion

Includes

Official

ICD-10-CM does not list Includes notes for M84.359 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M84.359 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M84.359 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M84.359 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M84.359 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

M84.359 is the ICD-10-CM diagnosis code for stress fracture, hip, unspecified. M84.359 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering disorders of bone density and structure (m80-m85).

Header codes like M84.359 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at M84.359's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M84.359 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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