Pathological fracture, right hand, subs for fx w nonunion

This code signifies a fracture in the right hand that occurred due to a pre-existing disease or condition, rather than trauma. The fracture has not healed properly, resulting in a nonunion, and the patient is receiving follow-up care for this complication.

Apply this code for patients presenting for ongoing treatment of a right hand pathological fracture that has failed to unite. Documentation should clearly state "pathological fracture," specify the right hand, and indicate "nonunion" during a subsequent encounter.

• Requires an underlying condition (e.g., osteoporosis, tumor) to be coded first as the cause of the pathological fracture.
• Distinguish from malunion (M84.441P) where the fracture healed incorrectly, versus nonunion where it has not healed at all.
• Ensure the encounter is for follow-up care, not initial treatment, as indicated by "subsequent encounter."