Pathological fracture, l humerus, subs for fx w routn heal

This code signifies a fracture of the left humerus that occurred due to a pre-existing disease or condition, rather than significant trauma. This specific encounter is for ongoing treatment of the fracture, which is progressing with expected healing.

Apply this code for follow-up visits where a patient is receiving care for a left humeral pathological fracture that is healing routinely. Documentation should confirm the pathological nature of the fracture and indicate that the healing process is uncomplicated and progressing as expected.

• Ensure documentation clearly states the fracture is pathological and not traumatic.
• The 7th character "D" indicates a subsequent encounter with routine healing; do not use for initial treatment or delayed/nonunion healing.
• Always code the underlying disease causing the pathological fracture first, followed by this fracture code.