Pathological fracture, unspecified shoulder
ICD-10 M84.419 is a billable code used to indicate a diagnosis of pathological fracture, unspecified shoulder.
A pathological fracture of the shoulder occurs when a bone breaks due to an underlying disease process rather than from a traumatic injury. This type of fracture is often associated with conditions such as osteoporosis, which leads to decreased bone density and increased fragility. Osteoporosis is a systemic skeletal disorder characterized by low bone mass and deterioration of bone tissue, resulting in enhanced bone fragility and a consequent increase in fracture risk. Pathological fractures can also arise from other bone metabolism disorders, such as Paget's disease or metastatic cancer, where the structural integrity of the bone is compromised. The unspecified nature of this code indicates that the specific location of the fracture within the shoulder (e.g., proximal humerus, scapula) is not documented, which can complicate treatment and management. Accurate diagnosis and coding are crucial for appropriate treatment planning and reimbursement, as well as for tracking the prevalence of such fractures in populations at risk.
Detailed clinical notes describing the fracture, underlying conditions, and treatment plan.
Patients with osteoporosis presenting with shoulder pain and a history of falls.
Ensure that the documentation clearly states the pathological nature of the fracture.
Comprehensive evaluation of bone density and metabolic disorders.
Patients with diagnosed osteoporosis experiencing fractures.
Document any treatments for osteoporosis that may have contributed to the fracture.
Used when a patient with a pathological fracture requires joint aspiration.
Document the reason for aspiration and findings.
Orthopedic specialists should ensure clear documentation of the fracture type.
A pathological fracture occurs due to underlying disease processes that weaken the bone, while a traumatic fracture results from an external force or injury.
