Path fracture, unsp tibia and fibula, subs for fx w nonunion

This code signifies a fracture of the tibia and/or fibula that occurred due to a pre-existing disease or condition, rather than trauma. The fracture has failed to heal properly, resulting in a nonunion, and the patient is presenting for follow-up care related to this ongoing complication.

Apply this code when a patient with a pathological fracture of an unspecified lower leg bone (tibia or fibula) is seen for continued management of a nonunion. Documentation should clearly state the pathological nature of the fracture and the presence of nonunion, along with the "subsequent encounter" status.

• Ensure documentation specifies "pathological fracture" and "nonunion" to support this code.
• Do not use for initial encounters or for fractures healing normally; look for codes indicating "initial encounter" or "routine healing."
• Always sequence this code after the underlying disease responsible for the pathological fracture (e.g., osteoporosis, neoplasm).