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2025 ICD-10-CM code M84.542A

Pathological fracture in neoplastic disease of the left hand. This code applies to the initial encounter for the fracture.

An external cause code should be used if applicable (e.g., a fall).Code the underlying neoplasm as well.

Medical necessity is established by the presence of a fracture directly related to a neoplastic disease in the left hand. Treatment is necessary to manage pain, stabilize the fracture, and address the underlying condition.

Diagnosis involves patient history, physical exam, imaging (X-ray, MRI, CT, PET, bone scan), laboratory tests (blood tests, bone biopsy). Treatment may include pain medication, casting, treating the underlying neoplasm, and possibly surgery, physical therapy, and lifestyle changes.

In simple words: This code describes a broken bone in your left hand that happened because the bone was weakened by a tumor.It's used when you're seeing the doctor for the first time about this fracture.

A pathological fracture occurs when a bone breaks due to weakness caused by an underlying disease, rather than due to significant trauma. In this case, the underlying disease is a neoplastic disease (a tumor) in the left hand.This code is specifically for the initial encounter for the fracture.

Example 1: A patient with a known bone tumor in their left hand experiences sudden pain after lifting a light object.An X-ray confirms a fracture., A patient undergoing chemotherapy for cancer in their left hand develops a spontaneous fracture., A patient with a history of a benign bone tumor in their left hand falls and sustains a fracture at the site of the tumor.

Documentation should include evidence of the neoplastic disease, the location of the fracture in the left hand, and that this is the initial encounter for this fracture. Imaging reports, physical exam findings, and relevant lab results should be included.

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