Path fx in oth disease, l shoulder, subs for fx w nonunion

This code signifies a pathological fracture of the left shoulder that has failed to heal properly (nonunion) and is being treated in a subsequent encounter. The fracture occurred due to an underlying disease process, not from trauma to otherwise healthy bone.

Apply this code when a patient presents for ongoing management of a left shoulder fracture that is not uniting, and the fracture was caused by a systemic condition such as osteoporosis, metastatic cancer, or Paget's disease. Documentation should clearly state "pathological fracture," "left shoulder," "nonunion," and indicate a "subsequent encounter."

• Ensure the documentation explicitly states "nonunion" for the fracture. If it's a malunion, a different code from the M84.8- series would be appropriate.
• Always sequence the underlying disease causing the pathological fracture (e.g., osteoporosis, neoplastic disease) before this code.
• Verify the encounter type; "subsequent encounter" implies the patient is receiving routine care during the healing phase, not initial treatment.