Pathological fracture, left shoulder, subs for fx w nonunion

This code signifies a pathological fracture of the left shoulder that has failed to heal properly, indicating a nonunion. A pathological fracture occurs due to a disease process weakening the bone, rather than from trauma. The "subsequent encounter" designation means the patient is receiving routine care during the healing or recovery phase for this nonunion.

This code is appropriate for follow-up visits where a patient is being managed for a previously diagnosed pathological fracture of the left shoulder that has developed a nonunion. Documentation should clearly state "pathological fracture," specify the left shoulder, confirm nonunion, and indicate that the encounter is for ongoing care, such as cast changes, medication management, or monitoring of healing.

• Always confirm the laterality (left shoulder) and the type of fracture (pathological) from the documentation.
• Distinguish between malunion (healed in a deformed position) and nonunion (failure to heal) as these have different codes.
• Ensure the encounter is truly "subsequent" for ongoing care; initial treatment of the nonunion would use a different encounter type.