Type III occipital condyle fracture, right side, 7thG

This code describes a specific fracture of the right occipital condyle, classified as Type III, indicating a comminuted fracture involving the foramen magnum. The "subsequent encounter" designation signifies that the patient is receiving routine care during the healing phase, but the healing process is progressing slower than expected.

This code is appropriate for follow-up visits where a patient with a previously diagnosed right Type III occipital condyle fracture is being managed for delayed healing. Documentation should clearly state "delayed healing" or similar terminology, along with the specific fracture type and laterality. Imaging reports confirming the fracture and ongoing clinical notes detailing the delayed healing process are essential.

• Ensure documentation explicitly states "delayed healing" for the subsequent encounter. If healing is progressing normally, a different subsequent encounter code would be used.
• Verify the laterality (right) and the specific fracture type (Type III) are clearly documented.
• Do not use this code for initial encounters or for nonunion, which has a distinct code.