Path fx in oth disease, r humerus, subs for fx w malunion

This code signifies a fracture of the right humerus that occurred due to an underlying disease process, not trauma, and has healed incorrectly (malunion). The patient is currently receiving follow-up care for this previously treated pathological fracture. The malunion indicates that the bone fragments have united in a deformed position, potentially causing functional impairment.

Use this code for patients presenting for ongoing treatment or evaluation of a right humeral pathological fracture that has healed with malunion. Documentation should clearly state the pathological nature of the fracture, its location in the right humerus, evidence of malunion, and that this is a subsequent encounter for the fracture. This code is appropriate when the patient is beyond the initial healing phase and is being managed for the consequences of the malunion.

• Always identify the underlying disease causing the pathological fracture; this will require an additional code.
• Ensure documentation specifies "malunion" and not "nonunion" (which has a different code category).
• Verify the encounter type is "subsequent" for the fracture, indicating ongoing care after the initial treatment.