S62.013K Displaced fracture of distal pole of navicular [scaphoid] bone of unspecified wrist, subsequent encounter for fracture with nonunion

Name of the Condition

• Displaced fracture of distal pole of navicular [scaphoid] bone of unspecified wrist, subsequent encounter for fracture with nonunion

Summary

A displaced fracture of the distal pole of the navicular (scaphoid) bone in the unspecified wrist involves a break in the lower portion of this small, critical wrist bone, with the bone fragments shifted out of their normal alignment. This is a subsequent encounter for treatment, indicating the fracture has not healed (nonunion) and requires ongoing management. The scaphoid’s role in wrist stability means nonunion can disrupt function and may necessitate specialized interventions.

Causes

Typically results from a fall onto an outstretched hand (FOOSH). Can also occur due to direct trauma to the wrist, such as a blow or impact. May involve twisting injuries or high-force activities that stress the wrist, leading to a fracture that fails to heal properly over time.

Risk Factors

• Participation in contact sports or activities with a high risk of falls.
• Osteoporosis or weakened bone structure, particularly in older adults.
• Previous wrist injuries or fractures that may compromise bone integrity.
• Poor blood supply to the scaphoid, which can impede healing.

Symptoms

• Persistent pain and tenderness localized to the wrist, especially near the base of the thumb.
• Swelling and bruising around the wrist area that may not resolve.
• Decreased range of motion or difficulty gripping objects.
• Possible deformity if the fracture remains significantly displaced.

Diagnosis

Physical examination to assess pain, swelling, and wrist mobility. Imaging tests, such as X-rays, CT scans, or MRI, to visualize the fracture and confirm nonunion. Additional tests may evaluate blood flow to the scaphoid or assess for associated complications.

Treatment Options

Treatment depends on the severity of displacement and nonunion. Options may include immobilization with a cast or brace, surgical intervention (e.g., bone grafting, internal fixation), or physical therapy to restore function. Pain management and activity modification are often part of the plan.

Prognosis and Follow-Up

Prognosis varies based on the extent of nonunion and treatment response. Regular follow-up with imaging is typically required to monitor healing. Long-term outcomes may include persistent pain, reduced wrist mobility, or the need for additional procedures if nonunion persists.

Complications

• Chronic pain or arthritis in the wrist.
• Reduced grip strength or functional limitations.
• Increased risk of future fractures due to weakened bone.
• Nerve or tendon damage in severe cases.

Lifestyle & Prevention

• Avoid high-risk activities that may cause wrist trauma.
• Use protective gear during sports or manual labor.
• Maintain bone health through proper nutrition and exercise.
• Follow post-treatment guidelines to support healing and prevent re-injury.

When to Seek Professional Help

Seek care if pain worsens, swelling increases, or mobility declines. Prompt evaluation is important if numbness, tingling, or signs of infection (e.g., redness, fever) occur, as these may indicate complications.

Tips for Medical Coders

This code is used for a subsequent encounter for a displaced fracture of the distal pole of the navicular (scaphoid) bone with nonunion. Documentation should specify the fracture’s displacement, the nonunion status, and that this is a follow-up visit. Ensure the encounter type (subsequent) and the presence of nonunion are clearly recorded to support accurate coding.