Pathological fracture in neoplastic disease, pelvis, sequela

This code signifies a bone fracture in the pelvis that occurred due to an underlying neoplastic (cancerous) process, and the patient is now experiencing a long-term effect or complication of that fracture. It indicates that the fracture itself is no longer acute but has left a residual condition.

Apply this code when documentation specifies a pathological fracture of the pelvis caused by cancer, and the encounter is for the management of a sequela (e.g., chronic pain, nonunion, malunion, functional impairment) directly attributable to that past fracture. The medical record should clearly state the fracture is resolved but has ongoing consequences.

• Always sequence the underlying neoplasm code first, followed by this sequela code.
• Ensure documentation explicitly states "sequela" or describes a chronic condition resulting from a resolved pathological fracture.
• Do not use for acute pathological fractures; those would be coded with the appropriate M84.55- acute fracture codes.