Pathological fracture, unsp toe(s), subs for fx w delay heal

This code signifies a fracture in an unspecified toe that occurred due to an underlying disease process, rather than trauma. The patient is in a subsequent phase of care, and the fracture is experiencing delayed healing, meaning it is taking longer than expected to mend.

Apply this code when a patient presents for follow-up care of a toe fracture that was caused by a pathological condition (e.g., osteoporosis, tumor), and the physician documents that the healing process is prolonged or not progressing as anticipated. Documentation should clearly state "pathological fracture," specify the toe(s) as "unspecified," and indicate "delayed healing" during a subsequent encounter.

• Ensure documentation explicitly states "pathological fracture" and "delayed healing" for the unspecified toe(s).
• Do not use this code for traumatic fractures; those require codes from the S92 category.
• This "G" seventh character indicates a subsequent encounter for a fracture with delayed healing; differentiate from "A" (initial encounter) or "K" (nonunion).