Radiology Coding Alert

Question: A patient was referred to our radiology practice by their primary care physician (PCP) to receive X-rays on their right foot. The patient was presenting a significant limp, swelling, and tenderness. The radiologist captured three views and noted fractures of the “2+3 R metatarsal.” The encounter notes list the diagnosis as a march fracture of the right foot.

How do I report a march fracture?

Massachusetts Subscriber

Answer: You’ll assign M84.374A (Stress fracture, right foot, initial encounter for fracture) to report the march fracture diagnosis.

Definition: According to the National Center for Biotechnology Information (NCBI), march fractures are “metatarsal fractures, most commonly second and third metatarsal fractures caused by an overuse injury. The repetitive impact to the metatarsals with weight-bearing exercises cause microfractures, which consolidate to stress fractures.”

One of the synonyms for M84.3- (Stress fracture) is march fracture, so if you see the term “march fracture” on encounter notes or a radiology report, you’ll know to select an applicable stress fracture code. March fracture helps specify the location of the fracture in the foot.

Don’t forget: Every code in the M84.3- code family requires an appropriate 7th character for greater specificity. For this question, using the 7th character “A” indicates an initial encounter for the fracture. Additional 7th character options for the M84.3- code family include:

• 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