Unsp fx upper end of unsp humerus, subs for fx w nonunion

This code signifies a persistent failure of bone healing in the upper part of the humerus, where the specific location of the fracture within the upper end is not documented. The patient is receiving ongoing care for this unhealed fracture, which has progressed to a nonunion.

Apply this code when a patient presents for follow-up treatment of an unhealed fracture of the proximal humerus, and the medical record does not specify the exact anatomical site (e.g., surgical neck, anatomical neck, greater tuberosity). This code is appropriate for subsequent encounters where nonunion is explicitly documented.

• Ensure documentation clearly states "nonunion" and that the encounter is for ongoing care, not initial treatment.
• Only use this code when the specific site of the fracture in the upper humerus is truly unspecified in the medical record.
• This code requires an additional code for any associated external cause, if applicable.