Path fx, unsp tibia and fibula, subs for fx w delay heal

This code signifies a fracture of the tibia and/or fibula that occurred due to an underlying disease process (e.g., osteoporosis, tumor) rather than trauma, and the patient is now in a subsequent phase of care where the fracture is not healing at the expected rate. It indicates ongoing management for a non-union or delayed union of the pathological fracture.

Apply this code for patients presenting for follow-up care of a pathological tibia/fibula fracture that has not yet achieved complete healing and is progressing slower than anticipated. Documentation should clearly state "pathological fracture," specify the tibia and/or fibula, and indicate "delayed healing" or similar terminology during a subsequent encounter.

• Ensure documentation explicitly states "pathological fracture" and not a traumatic fracture.
• Verify the encounter is for ongoing care of the fracture, not the initial treatment or a healed fracture.
• Always sequence the underlying disease causing the pathological fracture (e.g., M80.08XA for osteoporosis with pathological fracture, other site) as a primary or secondary diagnosis.