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2025 ICD-10-CM code S42.494G

Nondisplaced fracture of the lower end of the right humerus, subsequent encounter for fracture with delayed healing.

Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury unless the T-code includes the external cause.

Medical necessity is established by the presence of a documented nondisplaced fracture of the lower end of the right humerus with evidence of delayed healing, impacting the patient's function and requiring ongoing medical care.

IMPORTANT Consider Z18.- if there's a retained foreign body.

In simple words: This code represents a follow-up visit for a fracture at the lower end of your right upper arm bone, near the elbow. The bone is broken, but the pieces are still aligned. The bone is healing slower than expected.

Other nondisplaced fracture of lower end of right humerus, subsequent encounter for fracture with delayed healing. This code describes a break in the distal part of the right humerus (the bone between the shoulder and elbow) without misalignment of the fractured fragments. The patient is being seen for delayed healing of the fracture, meaning the bone is not healing as expected.

Example 1: A patient initially presented with a nondisplaced fracture of the lower end of the right humerus six weeks ago. The fracture was treated with a splint, but follow-up X-rays show signs of delayed healing., A patient who sustained a nondisplaced fracture of the lower end of the right humerus two months prior returns for a check-up. The physician notes that the healing process is significantly slower than anticipated., A patient is experiencing persistent pain and stiffness in their right elbow several weeks after a fall. They initially received a diagnosis of a nondisplaced fracture of the distal right humerus. During this encounter, the physician determines that the fracture is showing signs of delayed healing.

Initial encounter documentation for the fracture diagnosis. Follow-up visit documentation indicating delayed healing based on clinical findings and imaging studies like X-rays. Treatment plan for the delayed healing.

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