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2025 ICD-10-CM code S02.839G

Fracture of medial orbital wall, unspecified side, subsequent encounter for fracture with delayed healing.

Use secondary codes from Chapter 20 (External causes of morbidity) to indicate the cause of the initial injury.Also, code any associated conditions, such as retained foreign bodies or infections.

Medical necessity is established by the presence of a documented fracture with evidence of delayed healing, impacting the patient's function or causing ongoing symptoms.Further treatment and monitoring are deemed necessary to address these issues.

The physician is responsible for documenting the delayed healing of the fracture and providing appropriate care, which may include pain management, follow-up imaging, and referral to specialists if necessary.

In simple words: This code represents a follow-up visit for a fracture in the inner bone of the eye socket that is not healing as quickly as it should.

Fracture of medial orbital wall, unspecified side, subsequent encounter for fracture with delayed healing. This code describes a fracture affecting the medial wall of the eye socket, without specifying which side (left or right). It is used for encounters after the initial visit, indicating the fracture is healing slower than expected.

Example 1: A patient initially presented with a closed fracture of the medial orbital wall two weeks ago. During a follow-up appointment, the physician notes that the fracture shows signs of delayed healing and requires further monitoring., A patient who sustained a fracture of the medial orbital wall in a motor vehicle accident is experiencing persistent pain and limited eye movement several weeks after the initial injury. Imaging reveals delayed healing of the fracture., A patient with a history of diabetes presents for a follow-up appointment regarding a medial orbital wall fracture. The physician observes that the fracture is healing slower than expected due to the patient's underlying condition.

Documentation should include the initial date of injury, details of the original fracture, evidence of delayed healing (e.g., imaging studies, physical exam findings), treatment plan, and any associated complications.

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