Pathological fracture, unsp toe(s), subs for fx w nonunion

This code signifies a pathological fracture of an unspecified toe that has failed to heal properly, indicating a nonunion. A pathological fracture occurs due to an underlying disease weakening the bone, rather than from trauma. This specific code is for a subsequent encounter, meaning the patient is receiving active treatment for the nonunion.

Apply this code when documentation clearly indicates a pathological fracture of a toe (or toes) that has not united and the patient is undergoing follow-up care for this complication. This code is appropriate when the physician explicitly states "nonunion" or describes the fracture as failing to heal in the context of a pathological origin.

• Requires documentation of both "pathological fracture" and "nonunion" of the toe(s).
• The "K" seventh character indicates a subsequent encounter for a nonunion. Ensure the patient is receiving active treatment for the nonunion, not just routine follow-up after healing.
• Do not use if the fracture is traumatic in nature; instead, refer to the traumatic fracture codes with nonunion seventh characters.