Stress fracture, right tibia, sequela

This code signifies a stress fracture of the right tibia where the acute injury has healed, but the patient is experiencing residual effects or complications directly attributable to the past fracture. These sequelae could include chronic pain, deformity, nonunion, malunion, or functional limitations. It indicates that the current patient encounter addresses these long-term consequences rather than the initial acute fracture.

Use this code when a patient presents with ongoing symptoms or conditions stemming from a previously sustained stress fracture of the right tibia. Documentation should clearly state that the current problem is a "sequela" or "late effect" of a healed stress fracture, or describe a chronic condition directly resulting from the past injury. This code is appropriate for follow-up care addressing the long-term impact of the fracture.

• Always sequence this code after the code(s) identifying the specific sequela (e.g., chronic pain, nonunion).
• Ensure documentation explicitly links the current condition to the healed stress fracture of the right tibia.
• Do not use this code for an active, acute, or healing stress fracture; those require codes from the M84.361- series without the "S" seventh character.