Pathological fracture, r shoulder, subs for fx w routn heal

This code signifies a fracture of the right shoulder that occurred due to an underlying disease process, rather than trauma, and is currently in the routine healing phase. The patient is receiving follow-up care for this previously diagnosed pathological fracture.

Apply this code when documentation indicates a patient is presenting for a follow-up visit for a right shoulder fracture that was caused by a pre-existing condition (e.g., osteoporosis, tumor). The encounter should reflect routine healing without complications or delayed union.

• Ensure documentation clearly specifies "pathological fracture" and the right shoulder as the affected site.
• The "D" seventh character indicates a subsequent encounter for routine healing; do not use for initial treatment or complicated healing.
• Always code the underlying condition causing the pathological fracture first, followed by this fracture code.