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  6. 2024 ICD-10-CM Code S42.45
Version 2024
Non-Billable Code

2024 ICD-10-CM Diagnosis Code S42.45

Fracture of lateral condyle of humerus

ICD-10-CM Code:
S42.45
ICD-10 Code for:
Fracture of lateral condyle 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)

S42.45 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 lateral condyle 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 lateral condyle of humerus

Non-specific codes like S42.45 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 lateral condyle of humerus:

  • 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

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 capitellum of humerus

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

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.