Pathological fracture in oth disease, right humerus, sequela

This code signifies a fracture of the right humerus that occurred due to an underlying disease process, rather than trauma, and represents a late effect or complication of that fracture. It indicates that the acute phase of the pathological fracture has passed, and the patient is now experiencing residual conditions or complications directly attributable to it.

Apply this code when documentation clearly states a pathological fracture of the right humerus, caused by a systemic or localized disease (e.g., osteoporosis, metastatic cancer, Paget's disease), and the encounter is for treatment of a long-term consequence or sequela of that fracture. This code is appropriate for follow-up care, rehabilitation, or management of chronic pain or deformity resulting from the healed or non-union pathological fracture.

• Always sequence the underlying disease causing the pathological fracture first, if it is still active and relevant to the encounter.
• Ensure documentation explicitly states "sequela" or describes a late effect of the pathological fracture, not an acute or initial encounter.
• Distinguish from M84.5- (Pathological fracture in neoplastic disease) and M84.4- (Pathological fracture, not elsewhere classified) when the underlying disease is not neoplastic.