Version 2024

2024 ICD-10-CM Diagnosis Code S42.2

Fracture of upper end of humerus

ICD-10-CM Code:
S42.2
ICD-10 Code for:
Fracture of upper 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)

S42.2 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 upper 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 upper end of humerus

Non-specific codes like S42.2 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 upper end of humerus:

  • S42.20 for Unspecified fracture of upper end of humerus - NON-BILLABLE CODE

  • S42.201 for Unspecified fracture of upper end of right humerus - NON-BILLABLE CODE

  • Use S42.201A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.201B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.201D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.201G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.201K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.201P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.201S for sequela - BILLABLE CODE

  • S42.202 for Unspecified fracture of upper end of left humerus - NON-BILLABLE CODE

  • Use S42.202A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.202B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.202D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.202G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.202K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.202P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.202S for sequela - BILLABLE CODE

  • S42.209 for Unspecified fracture of upper end of unspecified humerus - NON-BILLABLE CODE

  • Use S42.209A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.209B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.209D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.209G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.209K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.209P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.209S for sequela - BILLABLE CODE

  • S42.21 for Unspecified fracture of surgical neck of humerus - NON-BILLABLE CODE

  • S42.211 for Unspecified displaced fracture of surgical neck of right humerus - NON-BILLABLE CODE

  • Use S42.211A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.211B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.211D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.211G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.211K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.211P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.211S for sequela - BILLABLE CODE

  • S42.212 for Unspecified displaced fracture of surgical neck of left humerus - NON-BILLABLE CODE

  • Use S42.212A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.212B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.212D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.212G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.212K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.212P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.212S for sequela - BILLABLE CODE

  • S42.213 for Unspecified displaced fracture of surgical neck of unspecified humerus - NON-BILLABLE CODE

  • Use S42.213A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.213B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.213D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.213G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.213K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.213P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.213S for sequela - BILLABLE CODE

  • S42.214 for Unspecified nondisplaced fracture of surgical neck of right humerus - NON-BILLABLE CODE

  • Use S42.214A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.214B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.214D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.214G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.214K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.214P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.214S for sequela - BILLABLE CODE

  • S42.215 for Unspecified nondisplaced fracture of surgical neck of left humerus - NON-BILLABLE CODE

  • Use S42.215A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.215B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.215D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.215G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.215K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.215P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.215S for sequela - BILLABLE CODE

  • S42.216 for Unspecified nondisplaced fracture of surgical neck of unspecified humerus - NON-BILLABLE CODE

  • Use S42.216A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.216B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.216D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.216G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.216K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.216P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.216S for sequela - BILLABLE CODE

  • S42.22 for 2-part fracture of surgical neck of humerus - NON-BILLABLE CODE

  • S42.221 for 2-part displaced fracture of surgical neck of right humerus - NON-BILLABLE CODE

  • Use S42.221A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.221B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.221D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.221G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.221K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.221P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.221S for sequela - BILLABLE CODE

  • S42.222 for 2-part displaced fracture of surgical neck of left humerus - NON-BILLABLE CODE

  • Use S42.222A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.222B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.222D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.222G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.222K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.222P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.222S for sequela - BILLABLE CODE

  • S42.223 for 2-part displaced fracture of surgical neck of unspecified humerus - NON-BILLABLE CODE

  • Use S42.223A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.223B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.223D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.223G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.223K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.223P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.223S for sequela - BILLABLE CODE

  • S42.224 for 2-part nondisplaced fracture of surgical neck of right humerus - NON-BILLABLE CODE

  • Use S42.224A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.224B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.224D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.224G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.224K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.224P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.224S for sequela - BILLABLE CODE

  • S42.225 for 2-part nondisplaced fracture of surgical neck of left humerus - NON-BILLABLE CODE

  • Use S42.225A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.225B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.225D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.225G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.225K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.225P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.225S for sequela - BILLABLE CODE

  • S42.226 for 2-part nondisplaced fracture of surgical neck of unspecified humerus - NON-BILLABLE CODE

  • Use S42.226A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.226B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.226D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.226G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.226K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.226P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.226S for sequela - BILLABLE CODE

  • S42.23 for 3-part fracture of surgical neck of humerus - NON-BILLABLE CODE

  • S42.231 for 3-part fracture of surgical neck of right humerus - NON-BILLABLE CODE

  • Use S42.231A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.231B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.231D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.231G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.231K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.231P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.231S for sequela - BILLABLE CODE

  • S42.232 for 3-part fracture of surgical neck of left humerus - NON-BILLABLE CODE

  • Use S42.232A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.232B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.232D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.232G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.232K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.232P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.232S for sequela - BILLABLE CODE

  • S42.239 for 3-part fracture of surgical neck of unspecified humerus - NON-BILLABLE CODE

  • Use S42.239A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.239B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.239D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.239G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.239K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.239P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.239S for sequela - BILLABLE CODE

  • S42.24 for 4-part fracture of surgical neck of humerus - NON-BILLABLE CODE

  • S42.241 for 4-part fracture of surgical neck of right humerus - NON-BILLABLE CODE

  • Use S42.241A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.241B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.241D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.241G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.241K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.241P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.241S for sequela - BILLABLE CODE

  • S42.242 for 4-part fracture of surgical neck of left humerus - NON-BILLABLE CODE

  • Use S42.242A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.242B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.242D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.242G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.242K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.242P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.242S for sequela - BILLABLE CODE

  • S42.249 for 4-part fracture of surgical neck of unspecified humerus - NON-BILLABLE CODE

  • Use S42.249A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.249B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.249D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.249G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.249K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.249P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.249S for sequela - BILLABLE CODE

  • S42.25 for Fracture of greater tuberosity of humerus - NON-BILLABLE CODE

  • S42.251 for Displaced fracture of greater tuberosity of right humerus - NON-BILLABLE CODE

  • Use S42.251A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.251B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.251D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.251G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.251K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.251P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.251S for sequela - BILLABLE CODE

  • S42.252 for Displaced fracture of greater tuberosity of left humerus - NON-BILLABLE CODE

  • Use S42.252A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.252B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.252D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.252G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.252K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.252P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.252S for sequela - BILLABLE CODE

  • S42.253 for Displaced fracture of greater tuberosity of unspecified humerus - NON-BILLABLE CODE

  • Use S42.253A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.253B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.253D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.253G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.253K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.253P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.253S for sequela - BILLABLE CODE

  • S42.254 for Nondisplaced fracture of greater tuberosity of right humerus - NON-BILLABLE CODE

  • Use S42.254A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.254B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.254D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.254G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.254K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.254P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.254S for sequela - BILLABLE CODE

  • S42.255 for Nondisplaced fracture of greater tuberosity of left humerus - NON-BILLABLE CODE

  • Use S42.255A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.255B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.255D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.255G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.255K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.255P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.255S for sequela - BILLABLE CODE

  • S42.256 for Nondisplaced fracture of greater tuberosity of unspecified humerus - NON-BILLABLE CODE

  • Use S42.256A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.256B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.256D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.256G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.256K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.256P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.256S for sequela - BILLABLE CODE

  • S42.26 for Fracture of lesser tuberosity of humerus - NON-BILLABLE CODE

  • S42.261 for Displaced fracture of lesser tuberosity of right humerus - NON-BILLABLE CODE

  • Use S42.261A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.261B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.261D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.261G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.261K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.261P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.261S for sequela - BILLABLE CODE

  • S42.262 for Displaced fracture of lesser tuberosity of left humerus - NON-BILLABLE CODE

  • Use S42.262A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.262B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.262D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.262G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.262K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.262P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.262S for sequela - BILLABLE CODE

  • S42.263 for Displaced fracture of lesser tuberosity of unspecified humerus - NON-BILLABLE CODE

  • Use S42.263A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.263B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.263D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.263G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.263K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.263P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.263S for sequela - BILLABLE CODE

  • S42.264 for Nondisplaced fracture of lesser tuberosity of right humerus - NON-BILLABLE CODE

  • Use S42.264A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.264B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.264D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.264G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.264K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.264P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.264S for sequela - BILLABLE CODE

  • S42.265 for Nondisplaced fracture of lesser tuberosity of left humerus - NON-BILLABLE CODE

  • Use S42.265A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.265B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.265D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.265G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.265K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.265P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.265S for sequela - BILLABLE CODE

  • S42.266 for Nondisplaced fracture of lesser tuberosity of unspecified humerus - NON-BILLABLE CODE

  • Use S42.266A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.266B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.266D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.266G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.266K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.266P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.266S for sequela - BILLABLE CODE

  • S42.27 for Torus fracture of upper end of humerus - NON-BILLABLE CODE

  • S42.271 for Torus fracture of upper end of right humerus - NON-BILLABLE CODE

  • Use S42.271A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.271D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.271G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.271K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.271P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.271S for sequela - BILLABLE CODE

  • S42.272 for Torus fracture of upper end of left humerus - NON-BILLABLE CODE

  • Use S42.272A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.272D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.272G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.272K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.272P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.272S for sequela - BILLABLE CODE

  • S42.279 for Torus fracture of upper end of unspecified humerus - NON-BILLABLE CODE

  • Use S42.279A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.279D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.279G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.279K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.279P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.279S for sequela - BILLABLE CODE

  • S42.29 for Other fracture of upper end of humerus - NON-BILLABLE CODE

  • S42.291 for Other displaced fracture of upper end of right humerus - NON-BILLABLE CODE

  • Use S42.291A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.291B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.291D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.291G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.291K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.291P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.291S for sequela - BILLABLE CODE

  • S42.292 for Other displaced fracture of upper end of left humerus - NON-BILLABLE CODE

  • Use S42.292A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.292B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.292D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.292G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.292K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.292P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.292S for sequela - BILLABLE CODE

  • S42.293 for Other displaced fracture of upper end of unspecified humerus - NON-BILLABLE CODE

  • Use S42.293A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.293B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.293D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.293G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.293K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.293P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.293S for sequela - BILLABLE CODE

  • S42.294 for Other nondisplaced fracture of upper end of right humerus - NON-BILLABLE CODE

  • Use S42.294A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.294B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.294D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.294G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.294K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.294P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.294S for sequela - BILLABLE CODE

  • S42.295 for Other nondisplaced fracture of upper end of left humerus - NON-BILLABLE CODE

  • Use S42.295A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.295B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.295D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.295G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.295K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.295P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.295S for sequela - BILLABLE CODE

  • S42.296 for Other nondisplaced fracture of upper end of unspecified humerus - NON-BILLABLE CODE

  • Use S42.296A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.296B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.296D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.296G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.296K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.296P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.296S 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).

Patient Education


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]

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
  • Dislocations
  • Separations
  • Tendinitis
  • Bursitis
  • Torn rotator cuffs
  • Frozen shoulder
  • Fractures (broken bones)
  • Arthritis

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 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.