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2025 ICD-10-CM code M84.359K

Stress fracture of the hip, unspecified, subsequent encounter for fracture with nonunion.

Use additional external cause codes (E-codes) to specify the cause of the stress fracture if applicable.This code is for subsequent encounters where nonunion is present.

Modifiers may be applicable depending on the specific circumstances of the encounter and services provided. Consult local payer guidelines.

Medical necessity is established by the persistence of symptoms and imaging evidence confirming nonunion of the fracture, necessitating further evaluation and treatment planning.

Diagnosis involves physical examination, review of patient history, lab tests (calcium and vitamin D levels), and imaging (X-ray, MRI, bone scan). Treatment may range from rest and lifestyle changes to splinting, medication (NSAIDs), or surgery.

IMPORTANT:Related codes may include those specifying the location of the hip fracture more precisely, or those specifying different outcomes of the fracture (e.g., malunion).

In simple words: This code is for a follow-up visit to the doctor for a hip stress fracture that hasn't healed correctly.A stress fracture is a small crack in the bone from overuse or repeated injury.This code is used when the fracture is not healing properly after a previous visit.

This ICD-10-CM code signifies a subsequent encounter for a stress fracture of the hip that has not healed or united after the initial fracture.It is used when the patient is seen again for this condition and the fracture remains unhealed.The location of the hip fracture is unspecified. This code is for use in situations where the bone fails to heal properly following an initial stress fracture.

Example 1: A 30-year-old female runner presents with persistent hip pain after a previous diagnosis of a stress fracture. Imaging shows nonunion.This code is used for the follow-up visit., A 55-year-old male reports continued hip pain and limited mobility 6 months after an initial stress fracture.Imaging confirms nonunion.This code applies to the subsequent encounter., A 40-year-old military recruit experiences continued hip pain despite treatment of a stress fracture. Radiographic evidence shows nonunion.This code is appropriate for subsequent encounters.

Medical record should include initial diagnosis of stress fracture, imaging reports demonstrating nonunion, documentation of prior treatment, and physician's notes outlining the current symptoms and plan of care.

** This code specifically addresses nonunion following a stress fracture.Other codes may be necessary for related conditions or complications.

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