M84.859 ICD-10-CM Code: Other disorders of continuity of bone, unspecified pelvic region and thigh

M84.859 is the ICD-10-CM diagnosis code for other disorders of continuity of bone, unspecified pelvic region and thigh. A bone disorder affecting the continuity or structural integrity of bone in the hip, pelvis, or thigh area when the specific side is not documented or is bilateral. M84.859 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).

M84.859 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Use this code only when laterality cannot be determined from documentation.