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  2. ICD-10-CM Codes
  3. S00–T88
  4. S40-S49
  5. S42
  6. 2024 ICD-10-CM Code S42.4
Version 2024
Non-Billable Code

2024 ICD-10-CM Diagnosis Code S42.4

Fracture of lower end of humerus

ICD-10-CM Code:
S42.4
ICD-10 Code for:
Fracture of lower 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)
      • Fracture of shoulder and upper arm
        (S42)

S42.4 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of fracture of lower 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 Fracture of lower end of humerus

Non-specific codes like S42.4 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 fracture of lower end of humerus:

  • S42.40 for Unspecified fracture of lower end of humerus - NON-BILLABLE CODE

  • S42.401 for Unspecified fracture of lower end of right humerus - NON-BILLABLE CODE

  • Use S42.401A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.401B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.401D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.401G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.401K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.401P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.401S for sequela - BILLABLE CODE

  • S42.402 for Unspecified fracture of lower end of left humerus - NON-BILLABLE CODE

  • Use S42.402A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.402B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.402D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.402G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.402K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.402P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.402S for sequela - BILLABLE CODE

  • S42.409 for Unspecified fracture of lower end of unspecified humerus - NON-BILLABLE CODE

  • Use S42.409A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.409B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.409D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.409G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.409K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.409P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.409S for sequela - BILLABLE CODE

  • S42.41 for Simple supracondylar fracture without intercondylar fracture of humerus - NON-BILLABLE CODE

  • S42.411 for Displaced simple supracondylar fracture without intercondylar fracture of right humerus - NON-BILLABLE CODE

  • Use S42.411A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.411B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.411D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.411G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.411K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.411P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.411S for sequela - BILLABLE CODE

  • S42.412 for Displaced simple supracondylar fracture without intercondylar fracture of left humerus - NON-BILLABLE CODE

  • Use S42.412A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.412B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.412D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.412G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.412K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.412P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.412S for sequela - BILLABLE CODE

  • S42.413 for Displaced simple supracondylar fracture without intercondylar fracture of unspecified humerus - NON-BILLABLE CODE

  • Use S42.413A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.413B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.413D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.413G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.413K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.413P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.413S for sequela - BILLABLE CODE

  • S42.414 for Nondisplaced simple supracondylar fracture without intercondylar fracture of right humerus - NON-BILLABLE CODE

  • Use S42.414A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.414B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.414D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.414G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.414K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.414P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.414S for sequela - BILLABLE CODE

  • S42.415 for Nondisplaced simple supracondylar fracture without intercondylar fracture of left humerus - NON-BILLABLE CODE

  • Use S42.415A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.415B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.415D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.415G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.415K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.415P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.415S for sequela - BILLABLE CODE

  • S42.416 for Nondisplaced simple supracondylar fracture without intercondylar fracture of unspecified humerus - NON-BILLABLE CODE

  • Use S42.416A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.416B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.416D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.416G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.416K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.416P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.416S for sequela - BILLABLE CODE

  • S42.42 for Comminuted supracondylar fracture without intercondylar fracture of humerus - NON-BILLABLE CODE

  • S42.421 for Displaced comminuted supracondylar fracture without intercondylar fracture of right humerus - NON-BILLABLE CODE

  • Use S42.421A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.421B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.421D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.421G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.421K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.421P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.421S for sequela - BILLABLE CODE

  • S42.422 for Displaced comminuted supracondylar fracture without intercondylar fracture of left humerus - NON-BILLABLE CODE

  • Use S42.422A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.422B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.422D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.422G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.422K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.422P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.422S for sequela - BILLABLE CODE

  • S42.423 for Displaced comminuted supracondylar fracture without intercondylar fracture of unspecified humerus - NON-BILLABLE CODE

  • Use S42.423A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.423B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.423D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.423G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.423K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.423P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.423S for sequela - BILLABLE CODE

  • S42.424 for Nondisplaced comminuted supracondylar fracture without intercondylar fracture of right humerus - NON-BILLABLE CODE

  • Use S42.424A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.424B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.424D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.424G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.424K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.424P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.424S for sequela - BILLABLE CODE

  • S42.425 for Nondisplaced comminuted supracondylar fracture without intercondylar fracture of left humerus - NON-BILLABLE CODE

  • Use S42.425A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.425B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.425D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.425G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.425K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.425P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.425S for sequela - BILLABLE CODE

  • S42.426 for Nondisplaced comminuted supracondylar fracture without intercondylar fracture of unspecified humerus - NON-BILLABLE CODE

  • Use S42.426A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.426B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.426D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.426G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.426K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.426P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.426S for sequela - BILLABLE CODE

  • S42.43 for Fracture (avulsion) of lateral epicondyle of humerus - NON-BILLABLE CODE

  • S42.431 for Displaced fracture (avulsion) of lateral epicondyle of right humerus - NON-BILLABLE CODE

  • Use S42.431A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.431B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.431D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.431G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.431K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.431P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.431S for sequela - BILLABLE CODE

  • S42.432 for Displaced fracture (avulsion) of lateral epicondyle of left humerus - NON-BILLABLE CODE

  • Use S42.432A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.432B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.432D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.432G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.432K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.432P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.432S for sequela - BILLABLE CODE

  • S42.433 for Displaced fracture (avulsion) of lateral epicondyle of unspecified humerus - NON-BILLABLE CODE

  • Use S42.433A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.433B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.433D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.433G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.433K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.433P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.433S for sequela - BILLABLE CODE

  • S42.434 for Nondisplaced fracture (avulsion) of lateral epicondyle of right humerus - NON-BILLABLE CODE

  • Use S42.434A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.434B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.434D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.434G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.434K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.434P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.434S for sequela - BILLABLE CODE

  • S42.435 for Nondisplaced fracture (avulsion) of lateral epicondyle of left humerus - NON-BILLABLE CODE

  • Use S42.435A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.435B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.435D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.435G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.435K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.435P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.435S for sequela - BILLABLE CODE

  • S42.436 for Nondisplaced fracture (avulsion) of lateral epicondyle of unspecified humerus - NON-BILLABLE CODE

  • Use S42.436A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.436B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.436D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.436G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.436K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.436P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.436S for sequela - BILLABLE CODE

  • S42.44 for Fracture (avulsion) of medial epicondyle of humerus - NON-BILLABLE CODE

  • S42.441 for Displaced fracture (avulsion) of medial epicondyle of right humerus - NON-BILLABLE CODE

  • Use S42.441A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.441B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.441D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.441G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.441K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.441P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.441S for sequela - BILLABLE CODE

  • S42.442 for Displaced fracture (avulsion) of medial epicondyle of left humerus - NON-BILLABLE CODE

  • Use S42.442A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.442B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.442D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.442G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.442K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.442P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.442S for sequela - BILLABLE CODE

  • S42.443 for Displaced fracture (avulsion) of medial epicondyle of unspecified humerus - NON-BILLABLE CODE

  • Use S42.443A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.443B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.443D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.443G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.443K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.443P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.443S for sequela - BILLABLE CODE

  • S42.444 for Nondisplaced fracture (avulsion) of medial epicondyle of right humerus - NON-BILLABLE CODE

  • Use S42.444A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.444B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.444D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.444G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.444K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.444P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.444S for sequela - BILLABLE CODE

  • S42.445 for Nondisplaced fracture (avulsion) of medial epicondyle of left humerus - NON-BILLABLE CODE

  • Use S42.445A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.445B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.445D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.445G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.445K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.445P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.445S for sequela - BILLABLE CODE

  • S42.446 for Nondisplaced fracture (avulsion) of medial epicondyle of unspecified humerus - NON-BILLABLE CODE

  • Use S42.446A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.446B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.446D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.446G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.446K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.446P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.446S for sequela - BILLABLE CODE

  • S42.447 for Incarcerated fracture (avulsion) of medial epicondyle of right humerus - NON-BILLABLE CODE

  • Use S42.447A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.447B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.447D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.447G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.447K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.447P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.447S for sequela - BILLABLE CODE

  • S42.448 for Incarcerated fracture (avulsion) of medial epicondyle of left humerus - NON-BILLABLE CODE

  • Use S42.448A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.448B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.448D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.448G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.448K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.448P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.448S for sequela - BILLABLE CODE

  • S42.449 for Incarcerated fracture (avulsion) of medial epicondyle of unspecified humerus - NON-BILLABLE CODE

  • Use S42.449A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.449B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.449D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.449G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.449K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.449P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.449S for sequela - BILLABLE CODE

  • S42.45 for Fracture of lateral condyle of humerus - NON-BILLABLE CODE

  • S42.451 for Displaced fracture of lateral condyle of right humerus - NON-BILLABLE CODE

  • Use S42.451A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.451B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.451D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.451G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.451K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.451P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.451S for sequela - BILLABLE CODE

  • S42.452 for Displaced fracture of lateral condyle of left humerus - NON-BILLABLE CODE

  • Use S42.452A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.452B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.452D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.452G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.452K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.452P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.452S for sequela - BILLABLE CODE

  • S42.453 for Displaced fracture of lateral condyle of unspecified humerus - NON-BILLABLE CODE

  • Use S42.453A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.453B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.453D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.453G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.453K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.453P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.453S for sequela - BILLABLE CODE

  • S42.454 for Nondisplaced fracture of lateral condyle of right humerus - NON-BILLABLE CODE

  • Use S42.454A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.454B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.454D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.454G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.454K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.454P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.454S for sequela - BILLABLE CODE

  • S42.455 for Nondisplaced fracture of lateral condyle of left humerus - NON-BILLABLE CODE

  • Use S42.455A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.455B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.455D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.455G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.455K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.455P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.455S for sequela - BILLABLE CODE

  • S42.456 for Nondisplaced fracture of lateral condyle of unspecified humerus - NON-BILLABLE CODE

  • Use S42.456A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.456B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.456D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.456G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.456K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.456P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.456S for sequela - BILLABLE CODE

  • S42.46 for Fracture of medial condyle of humerus - NON-BILLABLE CODE

  • S42.461 for Displaced fracture of medial condyle of right humerus - NON-BILLABLE CODE

  • Use S42.461A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.461B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.461D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.461G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.461K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.461P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.461S for sequela - BILLABLE CODE

  • S42.462 for Displaced fracture of medial condyle of left humerus - NON-BILLABLE CODE

  • Use S42.462A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.462B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.462D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.462G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.462K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.462P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.462S for sequela - BILLABLE CODE

  • S42.463 for Displaced fracture of medial condyle of unspecified humerus - NON-BILLABLE CODE

  • Use S42.463A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.463B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.463D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.463G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.463K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.463P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.463S for sequela - BILLABLE CODE

  • S42.464 for Nondisplaced fracture of medial condyle of right humerus - NON-BILLABLE CODE

  • Use S42.464A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.464B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.464D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.464G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.464K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.464P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.464S for sequela - BILLABLE CODE

  • S42.465 for Nondisplaced fracture of medial condyle of left humerus - NON-BILLABLE CODE

  • Use S42.465A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.465B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.465D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.465G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.465K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.465P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.465S for sequela - BILLABLE CODE

  • S42.466 for Nondisplaced fracture of medial condyle of unspecified humerus - NON-BILLABLE CODE

  • Use S42.466A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.466B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.466D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.466G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.466K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.466P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.466S for sequela - BILLABLE CODE

  • S42.47 for Transcondylar fracture of humerus - NON-BILLABLE CODE

  • S42.471 for Displaced transcondylar fracture of right humerus - NON-BILLABLE CODE

  • Use S42.471A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.471B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.471D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.471G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.471K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.471P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.471S for sequela - BILLABLE CODE

  • S42.472 for Displaced transcondylar fracture of left humerus - NON-BILLABLE CODE

  • Use S42.472A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.472B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.472D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.472G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.472K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.472P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.472S for sequela - BILLABLE CODE

  • S42.473 for Displaced transcondylar fracture of unspecified humerus - NON-BILLABLE CODE

  • Use S42.473A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.473B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.473D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.473G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.473K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.473P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.473S for sequela - BILLABLE CODE

  • S42.474 for Nondisplaced transcondylar fracture of right humerus - NON-BILLABLE CODE

  • Use S42.474A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.474B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.474D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.474G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.474K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.474P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.474S for sequela - BILLABLE CODE

  • S42.475 for Nondisplaced transcondylar fracture of left humerus - NON-BILLABLE CODE

  • Use S42.475A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.475B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.475D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.475G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.475K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.475P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.475S for sequela - BILLABLE CODE

  • S42.476 for Nondisplaced transcondylar fracture of unspecified humerus - NON-BILLABLE CODE

  • Use S42.476A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.476B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.476D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.476G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.476K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.476P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.476S for sequela - BILLABLE CODE

  • S42.48 for Torus fracture of lower end of humerus - NON-BILLABLE CODE

  • S42.481 for Torus fracture of lower end of right humerus - NON-BILLABLE CODE

  • Use S42.481A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.481D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.481G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.481K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.481P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.481S for sequela - BILLABLE CODE

  • S42.482 for Torus fracture of lower end of left humerus - NON-BILLABLE CODE

  • Use S42.482A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.482D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.482G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.482K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.482P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.482S for sequela - BILLABLE CODE

  • S42.489 for Torus fracture of lower end of unspecified humerus - NON-BILLABLE CODE

  • Use S42.489A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.489D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.489G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.489K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.489P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.489S for sequela - BILLABLE CODE

  • S42.49 for Other fracture of lower end of humerus - NON-BILLABLE CODE

  • S42.491 for Other displaced fracture of lower end of right humerus - NON-BILLABLE CODE

  • Use S42.491A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.491B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.491D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.491G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.491K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.491P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.491S for sequela - BILLABLE CODE

  • S42.492 for Other displaced fracture of lower end of left humerus - NON-BILLABLE CODE

  • Use S42.492A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.492B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.492D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.492G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.492K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.492P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.492S for sequela - BILLABLE CODE

  • S42.493 for Other displaced fracture of lower end of unspecified humerus - NON-BILLABLE CODE

  • Use S42.493A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.493B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.493D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.493G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.493K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.493P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.493S for sequela - BILLABLE CODE

  • S42.494 for Other nondisplaced fracture of lower end of right humerus - NON-BILLABLE CODE

  • Use S42.494A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.494B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.494D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.494G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.494K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.494P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.494S for sequela - BILLABLE CODE

  • S42.495 for Other nondisplaced fracture of lower end of left humerus - NON-BILLABLE CODE

  • Use S42.495A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.495B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.495D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.495G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.495K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.495P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.495S for sequela - BILLABLE CODE

  • S42.496 for Other nondisplaced fracture of lower end of unspecified humerus - NON-BILLABLE CODE

  • Use S42.496A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.496B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.496D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.496G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.496K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.496P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.496S 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).

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.


Inclusion Terms

Inclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
  • Fracture of distal end of humerus

Type 2 Excludes

Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
  • fracture of shaft of humerus S42.3
  • physeal fracture of lower end of humerus S49.1

Patient Education


Elbow Injuries and Disorders

Your elbow joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the elbow joint move. When any of these structures is hurt or diseased, you have elbow problems.

Many things can make your elbow hurt. A common cause is tendinitis, an inflammation or injury to the tendons that attach muscle to bone. Tendinitis of the elbow is a sports injury, often from playing tennis or golf. You may also get tendinitis from overuse of the elbow.

Other causes of elbow pain include sprains and strains, fractures (broken bones), dislocations, bursitis, and arthritis. Treatment depends on the cause.


[Learn More in MedlinePlus]

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]

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.