Pathological fracture, left toe(s), subs for fx w delay heal

This code signifies a fracture of one or more toes on the left foot that occurred due to an underlying disease process (e.g., osteoporosis, tumor), rather than trauma. The "G" seventh character indicates that the patient is in a subsequent encounter for this fracture, and the healing process is delayed.

Apply this code when a patient presents for follow-up care of a previously diagnosed pathological fracture of the left toe(s), and documentation explicitly states delayed healing. This typically involves ongoing management, cast changes, or monitoring of the fracture site. Documentation should clearly specify the pathological nature of the fracture and the left toe(s) involvement.

• Ensure documentation specifies "pathological" and not a traumatic fracture.
• Verify the laterality (left toe) and the specific seventh character for delayed healing (G).
• Always code the underlying condition causing the pathological fracture first.