Stress fracture, unsp toe(s), subs for fx w nonunion

This code signifies a stress fracture affecting an unspecified toe, indicating a pathological break in the bone due to repetitive stress rather than acute trauma. The "K" seventh character specifies that the fracture has failed to heal properly and is in a nonunion state, and the patient is presenting for follow-up care related to this complication.

Apply this code for patients presenting with an established diagnosis of a stress fracture in any toe, where previous treatment has not resulted in complete healing, and the fracture site is now considered a nonunion. Documentation should clearly state "stress fracture," "unspecified toe," and explicitly mention "nonunion" or lack of healing despite appropriate treatment.

• Ensure documentation specifies "stress fracture" and not a traumatic fracture; traumatic fractures of the toe have different coding pathways.
• Verify the "unspecified toe" aspect; if a specific toe is documented (e.g., great toe, second toe), a more specific code within the M84.37- series should be used.
• The "K" seventh character is crucial for nonunion; differentiate from "P" for malunion or "D" for routine healing.