Nondisp fx of med malleolus of r tibia, 7thP

This code describes a situation where a patient has a fracture of the inner ankle bone (medial malleolus) of the right lower leg that was not displaced at the time of injury. The fracture has subsequently healed, but with an imperfect alignment (malunion), and the patient is presenting for follow-up care related to this healing complication.

This code is appropriate for documenting follow-up visits for a patient whose previously sustained, nondisplaced right medial malleolus fracture has healed with malunion. This would include scenarios where the patient is being evaluated for pain, functional limitations, or considering further intervention due to the malunion. It is used after the initial treatment phase for the acute fracture.

• Ensure documentation clearly specifies "malunion" and not "nonunion" or "delayed union."
• Verify the fracture was initially "nondisplaced" and located on the "medial malleolus" of the "right tibia."
• This code is for subsequent encounters; an initial encounter for the acute fracture would use a different code.