AHA Coding Clinic® for ICD-9 - 2010 Issue 2; Ask the Editor

Impending Pathological Fracture Due to Multiple Myeloma

The patient is a 46-year-old man with multiple myeloma who was admitted to the hospital for management of pathologic fracture of the proximal shaft of the humerus. He also has impending pathologic fractures in multiple places of his left femur, which are very painful. CT scan of the femur demonstrated significant thinning of the medial wall, multiple cortical permeative changes involving the femur neck and permeative changes of the ischium. The patient is unable to bear weight; therefore the decision was made to undergo prophylactic cephalomedullary trochanteric nail fixation of the left femur as well as intramedullary nail fixation of the right humerus. How should this case be coded? ...

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