Stress fracture, oth site, subs for fx w nonunion

This code signifies a stress fracture located in an anatomical site other than those specifically classified elsewhere, which has failed to heal properly. The "subsequent encounter" indicates the patient is receiving routine care during the healing phase of the fracture, and "nonunion" confirms that the bone fragments have not united after a reasonable period.

Apply this code when documentation clearly states a stress fracture in an "other site" (e.g., rib, sternum, scapula) that has progressed to nonunion. This is appropriate for follow-up visits where the patient is being managed for the ongoing nonunion of the stress fracture. Supporting documentation should include imaging reports confirming nonunion and physician notes detailing the management plan.

• Ensure the documentation specifies "stress fracture" and not another type of fracture, and that the site is not more specifically coded elsewhere.
• Verify that "nonunion" is explicitly documented; do not assume nonunion based on prolonged healing.
• This code requires a seventh character of "K" for subsequent encounter for fracture with nonunion.