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  6. 2024 ICD-10-CM Code S42.29
Version 2024
Non-Billable Code

2024 ICD-10-CM Diagnosis Code S42.29

Other fracture of upper end of humerus

ICD-10-CM Code:
S42.29
ICD-10 Code for:
Other 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)

S42.29 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of other 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 Other fracture of upper end of humerus

Non-specific codes like S42.29 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 other fracture of upper end of humerus:

  • 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).

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 anatomical neck of humerus
  • Fracture of articular head 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


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


[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.