2022 ICD-10-CM Code S42.47

Transcondylar fracture of humerus

Version 2021

Not Valid for Submission

ICD-10:S42.47
Short Description:Transcondylar fracture of humerus
Long Description:Transcondylar fracture of humerus

Code Classification

  • Injury, poisoning and certain other consequences of external causes (S00–T98)
    • Injuries to the shoulder and upper arm (S40-S49)
      • Fracture of shoulder and upper arm (S42)

S42.47 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of transcondylar fracture of humerus. The code is not specific and is NOT valid for the year 2022 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.

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).

Specific Coding for Transcondylar fracture of humerus

Non-specific codes like S42.47 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for transcondylar fracture of humerus:

  • NON-BILLABLE CODE - S42.471 for Displaced transcondylar fracture of right humerus
  • 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
  • NON-BILLABLE CODE - S42.472 for Displaced transcondylar fracture of left humerus
  • 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
  • NON-BILLABLE CODE - S42.473 for Displaced transcondylar fracture of unspecified humerus
  • 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
  • NON-BILLABLE CODE - S42.474 for Nondisplaced transcondylar fracture of right humerus
  • 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
  • NON-BILLABLE CODE - S42.475 for Nondisplaced transcondylar fracture of left humerus
  • 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
  • NON-BILLABLE CODE - S42.476 for Nondisplaced transcondylar fracture of unspecified humerus
  • 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

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code S42.47 are found in the index:

Information for Patients


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

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 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 (First year ICD-10-CM implemented into the HIPAA code set)