Path fracture, unsp humerus, subs for fx w routn heal

This code signifies a fracture of the humerus that occurred due to an underlying disease process, rather than trauma. The patient is in the healing phase of this pathological fracture, and the healing is progressing as expected without complications. This indicates a follow-up encounter for ongoing management of the fracture.

Apply this code for follow-up visits where a patient is being monitored for a pathological fracture of an unspecified humerus that is healing routinely. Documentation should clearly state "pathological fracture," specify the humerus (even if unspecified as to laterality), and indicate "subsequent encounter" with "routine healing." This code is appropriate when the initial treatment for the fracture has been completed and the focus is on recovery.

• Ensure documentation explicitly states "pathological fracture" and not just a traumatic fracture.
• Verify the encounter is for subsequent care and not the initial treatment or a sequela.
• Do not use this code if the healing is delayed, nonunion, or malunion; specific codes exist for those complications.