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

This code signifies a pathological fracture of an unspecified toe that has healed improperly (malunion) and is being addressed in a subsequent encounter. A pathological fracture occurs due to an underlying disease weakening the bone, rather than from trauma. The malunion indicates that the bone fragments have united in a deformed or misaligned position.

Use this code for follow-up care of a toe fracture that occurred due to a pre-existing condition (e.g., osteoporosis, tumor) and has resulted in a malunion. Documentation should clearly state "pathological fracture," "malunion," and specify the toe(s) if known, otherwise "unspecified." This code is appropriate when the patient is receiving ongoing treatment for the malunion, such as physical therapy or planning for corrective surgery.

• Ensure documentation explicitly states "pathological fracture" and "malunion" for the toe(s).
• Always sequence this code after the underlying disease causing the pathological fracture.
• If the specific toe is known, use a more specific code from the M84.47- series (e.g., M84.471P for right great toe).