In simple words: A pathological fracture means a broken bone caused by a disease that weakened the bone. This code is used when the break happens in a place not listed in other codes, and it's for the first time you see a doctor for this fracture.

A pathologic fracture occurs in a bone weakened by an underlying disease process.This code is specific to fractures occurring at sites other than those specifically identified elsewhere in the M84.6 series, and it applies to the initial encounter for the fracture.It is essential to code also the underlying condition causing the pathological fracture.

Example 1: A patient with Paget's disease of bone presents with a new fracture in the right rib after a minor fall.The rib fracture is coded as M84.68XA, along with a code for Paget's disease., A patient with multiple myeloma experiences a spontaneous fracture of the left femur.The initial encounter is coded as M84.68XA, along with the code for multiple myeloma., A patient with bone metastases from breast cancer presents with a new fracture of the right humerus. The humerus fracture would be coded as M84.68XA, along with codes for the bone metastasis and the primary breast cancer.

Documentation should clearly indicate the presence of a pathological fracture, specify the affected site (e.g., rib, femur, humerus), and identify the underlying disease. Imaging reports confirming the fracture should be included.Documentation of the initial encounter for the fracture is required for the use of the XA 7th character.