Path fx in oth dis, unsp ulna & rad, subs for fx w malunion

This code signifies a fracture of the ulna and/or radius that occurred due to an underlying disease process, rather than trauma. The fracture has healed improperly, resulting in a malunion, and the patient is presenting for follow-up care related to this complication.

Apply this code when documentation indicates a pathological fracture of an unspecified ulna and/or radius, and the patient is being seen for ongoing management of a malunion. This code is appropriate for subsequent encounters after initial treatment, where the focus is on the malunion. Supporting documentation would include imaging reports confirming malunion and physician notes detailing the underlying disease and follow-up care.

• Ensure the documentation clearly states the fracture is pathological, not traumatic.
• Verify the encounter is for subsequent care of the malunion, not initial treatment or routine healing.
• Always code the underlying disease responsible for the pathological fracture first.