Pathological fracture, unspecified humerus, sequela

This code signifies a pathological fracture of an unspecified humerus that is now a sequela, meaning it represents the late effects or complications of a previously healed pathological fracture. A pathological fracture occurs due to a disease process weakening the bone, rather than from trauma. The "sequela" designation indicates that the acute phase of the fracture has passed, and the patient is experiencing residual effects.

Apply this code when a patient presents with a long-term complication or residual condition directly resulting from a healed pathological fracture of the humerus. Documentation should clearly state the pathological nature of the original fracture and describe the current sequela. This code is appropriate for follow-up care related to the lasting impact of the fracture, such as chronic pain, deformity, or functional limitation.

• Always sequence this code after the code describing the specific sequela (e.g., M21.9 for unspecified deformity).
• Ensure documentation explicitly states "pathological fracture" and the "sequela" or "late effect" status; avoid using for acute or initial encounters.
• Verify laterality (left, right) if specified in the documentation; "unspecified" humerus should only be used when laterality is not documented.