Injury of axillary nerve, left arm, subsequent encounter

This code signifies a documented injury to the axillary nerve in the patient's left arm, indicating a follow-up visit for this specific condition. The axillary nerve is crucial for shoulder movement and sensation, and its injury can lead to deltoid muscle weakness or paralysis and sensory deficits over the shoulder.

Apply this code when a patient presents for ongoing treatment, evaluation, or management of a previously diagnosed axillary nerve injury in the left arm. This includes visits for physical therapy, medication adjustments, or monitoring of recovery progress after the initial acute phase of the injury.

• Ensure documentation clearly specifies "left arm" and that the encounter is not the initial treatment for the injury.
• Always sequence this code after the primary reason for the encounter, if applicable.
• Look for keywords like "follow-up," "healing," "rehabilitation," or "status post" related to the axillary nerve injury.