Pathological fracture, left humerus, subs for fx w nonunion

This code signifies a fracture of the left humerus that occurred due to an underlying disease process, rather than trauma. The fracture has failed to heal properly (nonunion), and the patient is currently receiving routine follow-up care during the healing phase.

Apply this code when documentation indicates a pathological fracture of the left humerus with confirmed nonunion, and the patient is seen for ongoing management, such as cast changes, physical therapy, or medication adjustments, after initial treatment. Supporting documentation should clearly state "pathological fracture," "left humerus," and "nonunion," along with the "subsequent encounter" status.

• Always sequence the underlying disease causing the pathological fracture first, if known and actively treated.
• Distinguish carefully between "subsequent encounter for fracture with nonunion" (K) and "subsequent encounter for fracture with malunion" (P) or "subsequent encounter for fracture with routine healing" (D).
• Ensure the laterality (left humerus) is explicitly documented to support this specific code.