Pathological fracture, oth site, subs for fx w routn heal

This code signifies a bone fracture that occurred due to an underlying disease weakening the bone, rather than significant trauma, and is currently in a routine healing phase during a follow-up visit. The fracture is located in an anatomical site not specified by more granular codes.

Apply this code for follow-up encounters where a patient is being monitored for a pathological fracture in a non-specific location (e.g., rib, sternum, sacrum) that is healing as expected. Documentation should clearly state "pathological fracture," the specific site, and indicate a subsequent encounter for routine healing.

• Ensure the documentation specifies "pathological fracture" and not a traumatic fracture.
• Verify the fracture site is not more specifically coded elsewhere (e.g., M84.40-M84.47).
• This code requires a seventh character "D" for subsequent encounter, indicating routine healing.