Pathological fracture, oth site, subs for fx w nonunion

This code signifies a bone fracture that occurred due to a pre-existing disease, rather than trauma, in an unspecified anatomical location other than the ankle, foot, or spine. It specifically indicates that the fracture has failed to heal properly (nonunion) and the patient is receiving follow-up care for this complication.

Apply this code when a patient presents for ongoing treatment of a pathological fracture in a site not otherwise specified, and documentation confirms nonunion. This includes scenarios where the patient is undergoing further diagnostic workup, surgical intervention, or conservative management for the unhealed fracture. Supporting documentation must clearly state "pathological fracture," "nonunion," and "subsequent encounter."

• Always sequence this code after the underlying disease causing the pathological fracture (e.g., osteoporosis, neoplasm).
• Ensure the documentation specifies "nonunion" and "subsequent encounter" to differentiate from initial encounters or malunion.
• Avoid using this code for pathological fractures of the ankle, foot, or spine, as more specific codes exist for those sites.