Stress fracture, unsp shoulder, subs for fx w delay heal

This code signifies a stress fracture affecting an unspecified shoulder, indicating the specific location within the shoulder is not documented. The "G" seventh character specifies that this is a subsequent encounter for a fracture that is experiencing delayed healing.

Apply this code when a patient presents for follow-up care of a previously diagnosed stress fracture of the shoulder, and the provider explicitly notes that the healing process is not progressing as expected. Documentation should clearly state "delayed healing" and specify the shoulder as the affected site without further anatomical detail.

• Ensure documentation confirms a stress fracture, not a traumatic fracture, and specifies delayed healing.
• Verify that the encounter is for follow-up care, not initial treatment, to justify the "G" seventh character.
• If the specific bone (e.g., clavicle, scapula, humerus) is documented, a more specific code within the M84.31- category should be used.