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

This code signifies a fracture of the left shoulder that occurred due to an underlying disease process, not trauma. The patient is currently in a phase of routine healing following initial treatment for this pathological fracture.

Apply this code for follow-up visits where a patient is receiving ongoing care for a left shoulder fracture caused by a condition like osteoporosis or metastatic cancer, and the healing is progressing as expected. Documentation should clearly state "pathological fracture," specify the left shoulder, and indicate a subsequent encounter with routine healing.

• Ensure documentation explicitly states "pathological fracture" and not a traumatic fracture.
• Verify the laterality (left shoulder) is clearly documented.
• Do not use this code for initial treatment or for encounters involving delayed healing, nonunion, or malunion.