Not Valid for Submission
S42 is a "header" nonspecific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of fracture of shoulder and upper arm. The code is NOT valid for the year 2021 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.
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code S42:
Type 1 ExcludesType 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- traumatic amputation of shoulder and upper arm S48
7th Character Note7th Character Note
Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
- The appropriate 7th character is to be added to all codes from category S42
7th Character7th Character
Indicates that a seventh character is to be assigned to codes in a subcategory.
- A - initial encounter for closed fracture
- B - initial encounter for open fracture
- D - subsequent encounter for fracture with routine healing
- G - subsequent encounter for fracture with delayed healing
- K - subsequent encounter for fracture with nonunion
- P - subsequent encounter for fracture with malunion
- S - sequela
- A fracture not indicated as displaced or nondisplaced should be coded to displaced
- A fracture not indicated as open or closed should be coded to closed
Information for Patients
Also called: Broken bone
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.
- Broken bone (Medical Encyclopedia)
- Closed reduction of a fractured bone (Medical Encyclopedia)
- Closed reduction of a fractured bone - aftercare (Medical Encyclopedia)
[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
- Torn rotator cuffs
- Frozen shoulder
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
- Brachial plexopathy (Medical Encyclopedia)
- Broken collarbone - aftercare (Medical Encyclopedia)
- Frozen shoulder (Medical Encyclopedia)
- Frozen shoulder - aftercare (Medical Encyclopedia)
- Shoulder arthroscopy (Medical Encyclopedia)
- Shoulder CT scan (Medical Encyclopedia)
- Shoulder MRI scan (Medical Encyclopedia)
- Shoulder pain (Medical Encyclopedia)
- Using your shoulder after surgery (Medical Encyclopedia)
[Learn More in MedlinePlus]