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  6. 2024 ICD-10-CM Code S49.0
Version 2024
Non-Billable Code

2024 ICD-10-CM Diagnosis Code S49.0

Physeal fracture of upper end of humerus

ICD-10-CM Code:
S49.0
ICD-10 Code for:
Physeal fracture of upper end of humerus
Is Billable?
Not Valid for Submission
Code Navigator:

Code Classification

  • Injury, poisoning and certain other consequences of external causes
    (S00–T88)
    • Injuries to the shoulder and upper arm
      (S40-S49)
      • Other and unspecified injuries of shoulder and upper arm
        (S49)

S49.0 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of physeal fracture of upper end of humerus. The code is not specific and is NOT valid for the year 2024 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Specific Coding Applicable to Physeal fracture of upper end of humerus

Non-specific codes like S49.0 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for physeal fracture of upper end of humerus:

  • S49.00 for Unspecified physeal fracture of upper end of humerus - NON-BILLABLE CODE

  • S49.001 for Unspecified physeal fracture of upper end of humerus, right arm - NON-BILLABLE CODE

  • Use S49.001A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.001D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.001G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.001K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.001P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.001S for sequela - BILLABLE CODE

  • S49.002 for Unspecified physeal fracture of upper end of humerus, left arm - NON-BILLABLE CODE

  • Use S49.002A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.002D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.002G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.002K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.002P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.002S for sequela - BILLABLE CODE

  • S49.009 for Unspecified physeal fracture of upper end of humerus, unspecified arm - NON-BILLABLE CODE

  • Use S49.009A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.009D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.009G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.009K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.009P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.009S for sequela - BILLABLE CODE

  • S49.01 for Salter-Harris Type I physeal fracture of upper end of humerus - NON-BILLABLE CODE

  • S49.011 for Salter-Harris Type I physeal fracture of upper end of humerus, right arm - NON-BILLABLE CODE

  • Use S49.011A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.011D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.011G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.011K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.011P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.011S for sequela - BILLABLE CODE

  • S49.012 for Salter-Harris Type I physeal fracture of upper end of humerus, left arm - NON-BILLABLE CODE

  • Use S49.012A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.012D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.012G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.012K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.012P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.012S for sequela - BILLABLE CODE

  • S49.019 for Salter-Harris Type I physeal fracture of upper end of humerus, unspecified arm - NON-BILLABLE CODE

  • Use S49.019A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.019D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.019G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.019K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.019P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.019S for sequela - BILLABLE CODE

  • S49.02 for Salter-Harris Type II physeal fracture of upper end of humerus - NON-BILLABLE CODE

  • S49.021 for Salter-Harris Type II physeal fracture of upper end of humerus, right arm - NON-BILLABLE CODE

  • Use S49.021A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.021D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.021G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.021K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.021P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.021S for sequela - BILLABLE CODE

  • S49.022 for Salter-Harris Type II physeal fracture of upper end of humerus, left arm - NON-BILLABLE CODE

  • Use S49.022A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.022D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.022G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.022K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.022P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.022S for sequela - BILLABLE CODE

  • S49.029 for Salter-Harris Type II physeal fracture of upper end of humerus, unspecified arm - NON-BILLABLE CODE

  • Use S49.029A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.029D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.029G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.029K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.029P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.029S for sequela - BILLABLE CODE

  • S49.03 for Salter-Harris Type III physeal fracture of upper end of humerus - NON-BILLABLE CODE

  • S49.031 for Salter-Harris Type III physeal fracture of upper end of humerus, right arm - NON-BILLABLE CODE

  • Use S49.031A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.031D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.031G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.031K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.031P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.031S for sequela - BILLABLE CODE

  • S49.032 for Salter-Harris Type III physeal fracture of upper end of humerus, left arm - NON-BILLABLE CODE

  • Use S49.032A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.032D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.032G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.032K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.032P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.032S for sequela - BILLABLE CODE

  • S49.039 for Salter-Harris Type III physeal fracture of upper end of humerus, unspecified arm - NON-BILLABLE CODE

  • Use S49.039A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.039D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.039G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.039K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.039P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.039S for sequela - BILLABLE CODE

  • S49.04 for Salter-Harris Type IV physeal fracture of upper end of humerus - NON-BILLABLE CODE

  • S49.041 for Salter-Harris Type IV physeal fracture of upper end of humerus, right arm - NON-BILLABLE CODE

  • Use S49.041A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.041D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.041G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.041K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.041P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.041S for sequela - BILLABLE CODE

  • S49.042 for Salter-Harris Type IV physeal fracture of upper end of humerus, left arm - NON-BILLABLE CODE

  • Use S49.042A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.042D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.042G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.042K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.042P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.042S for sequela - BILLABLE CODE

  • S49.049 for Salter-Harris Type IV physeal fracture of upper end of humerus, unspecified arm - NON-BILLABLE CODE

  • Use S49.049A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.049D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.049G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.049K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.049P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.049S for sequela - BILLABLE CODE

  • S49.09 for Other physeal fracture of upper end of humerus - NON-BILLABLE CODE

  • S49.091 for Other physeal fracture of upper end of humerus, right arm - NON-BILLABLE CODE

  • Use S49.091A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.091D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.091G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.091K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.091P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.091S for sequela - BILLABLE CODE

  • S49.092 for Other physeal fracture of upper end of humerus, left arm - NON-BILLABLE CODE

  • Use S49.092A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.092D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.092G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.092K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.092P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.092S for sequela - BILLABLE CODE

  • S49.099 for Other physeal fracture of upper end of humerus, unspecified arm - NON-BILLABLE CODE

  • Use S49.099A for initial encounter for closed fracture - BILLABLE CODE

  • Use S49.099D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S49.099G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S49.099K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S49.099P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S49.099S for sequela - BILLABLE CODE

Coding Guidelines

The principles of multiple coding of injuries should be followed in coding fractures. Fractures of specified sites are coded individually by site nd the level of detail furnished by medical record content.

A fracture not indicated as open or closed should be coded to closed. A fracture not indicated whether displaced or not displaced should be coded to displaced.

Initial vs. Subsequent Encounter for Fractures

Traumatic fractures are coded using the appropriate 7th character for initial encounter (A, B, C) for each encounter where the patient is receiving active treatment for the fracture. The appropriate 7th character for initial encounter should also be assigned for a patient who delayed seeking treatment for the fracture or nonunion.

Fractures are coded using the appropriate 7th character for subsequent care for encounters after the patient has completed active treatment of the fracture and is receiving routine care for the fracture during the healing or recovery phase.

Care for complications of surgical treatment for fracture repairs during the healing or recovery phase should be coded with the appropriate complication codes.

Care of complications of fractures, such as malunion and nonunion, should be reported with the appropriate 7th character for subsequent care with nonunion (K, M, N,) or subsequent care with malunion (P, Q, R).

Malunion/nonunion: The appropriate 7th character for initial encounter should also be assigned for a patient who delayed seeking treatment for the fracture or nonunion.

The open fracture designations in the assignment of the 7th character for fractures of the forearm, femur and lower leg, including ankle are based on the Gustilo open fracture classification. When the Gustilo classification type is not specified for an open fracture, the 7th character for open fracture type I or II should be assigned (B, E, H, M, Q).

Patient Education


Fractures

A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open or compound fracture. Fractures commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the bone.

Symptoms of a fracture are:

  • Intense pain
  • Deformity - the limb looks out of place
  • Swelling, bruising, or tenderness around the injury
  • Numbness and tingling
  • Problems moving a limb

You need to get medical care right away for any fracture. An x-ray can tell if your bone is broken. You may need to wear a cast or splint. Sometimes you need surgery to put in plates, pins or screws to keep the bone in place.


[Learn More in MedlinePlus]

Shoulder Injuries and Disorders

Your shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone). Your shoulders are the most movable joints in your body. They can also be unstable because the ball of the upper arm is larger than the shoulder socket that holds it. To remain in a stable or normal position, the shoulder must be anchored by muscles, tendons, and ligaments.

Because your shoulder can be unstable, it can be easily injured. Common problems include:

  • Sprains and strains
  • Dislocations
  • Separations
  • Tendinitis
  • Bursitis
  • Torn rotator cuffs
  • Frozen shoulder
  • Fractures (broken bones)
  • Arthritis

Health care providers diagnose shoulder problems by using your medical history, a physical exam, and imaging tests.

Often, the first treatment for shoulder problems is RICE. This stands for Rest, Ice, Compression, and Elevation. Other treatments include exercise and medicines to reduce pain and swelling. If those don't work, you may need surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.