2021 ICD-10-CM Code S42.90

Fracture of unspecified shoulder girdle, part unspecified

Version 2021
Non-Billable Code
Unspecified Code

Not Valid for Submission

S42.90 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 unspecified shoulder girdle, part unspecified. 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.

Unspecified diagnosis codes like S42.90 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

ICD-10:S42.90
Short Description:Fracture of unspecified shoulder girdle, part unspecified
Long Description:Fracture of unspecified shoulder girdle, part unspecified

Code Classification

Specific Coding for Fracture of unspecified shoulder girdle, part unspecified

Header codes like S42.90 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 fracture of unspecified shoulder girdle, part unspecified:

  • S42.90XA - ... initial encounter for closed fracture
  • S42.90XB - ... initial encounter for open fracture
  • S42.90XD - ... subsequent encounter for fracture with routine healing
  • S42.90XG - ... subsequent encounter for fracture with delayed healing
  • S42.90XK - ... subsequent encounter for fracture with nonunion
  • S42.90XP - ... subsequent encounter for fracture with malunion
  • S42.90XS - ... sequela

Information for Patients


Fractures

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

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

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


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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)