2025 ICD-10-CM code M84.529K
Pathological fracture in neoplastic disease, unspecified humerus, subsequent encounter for fracture with nonunion.
Medical necessity is established by the presence of a pathological fracture directly related to a neoplastic disease and the need for ongoing care due to nonunion.
Diagnosis involves patient history, physical exam, and imaging (X-ray, MRI, CT, PET, bone scan). Treatment includes pain management, casting, treating the underlying tumor, potential surgery, physical therapy, and lifestyle adjustments.
- Diseases of the musculoskeletal system and connective tissue (M00-M99)
- Disorders of bone density and structure (M80-M85)
In simple words: This code refers to a broken upper arm bone caused by a tumor, where the bone hasn't healed properly in a follow-up visit.
This code describes a non-traumatic fracture of the humerus (upper arm bone) due to weakening by a neoplastic disease (tumor). It is used for subsequent encounters where the fracture has failed to heal (nonunion).
Example 1: A patient with bone cancer experiences a spontaneous humerus fracture. After initial treatment, follow-up visits reveal the fracture hasn't united., A patient with a benign bone tumor in their humerus sustains a fracture after a minor fall. Subsequent imaging shows nonunion., A patient undergoing treatment for metastatic bone cancer in the humerus presents with a new fracture that fails to heal despite immobilization.
Documentation should include evidence of the underlying neoplastic disease, the fracture, the failed healing process (nonunion), and details of all encounters and treatments.
- Payment Status: Active
- Specialties:Oncology, Orthopedic Surgery, Radiology
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, etc.