Fracture of base of skull, right side, sequela

This code signifies a long-term complication or late effect resulting from a fracture to the right side of the skull base. It indicates that the initial acute injury has resolved, but the patient continues to experience residual problems directly attributable to that specific fracture. Examples of sequelae include chronic pain, neurological deficits, or persistent CSF leaks.

Assign this code when documenting a patient presenting with a current condition that is a direct consequence of a previously sustained fracture of the right skull base. The medical record must clearly link the current symptom or condition to the old fracture. This code is appropriate for follow-up visits addressing these chronic issues, not for the initial acute injury.

• Always sequence the sequela code first, followed by codes for the specific manifestation(s) of the sequela (e.g., chronic headache, cranial nerve palsy).
• Ensure documentation explicitly states the condition is a "sequela," "late effect," or "due to old fracture" of the right skull base.
• Do not use this code for acute fractures; use the appropriate acute S02.101- code for the initial injury.