S42 Non-Billable Code

Fracture of shoulder and upper arm

Chapter Classification

Chapter 19 Injury, poisoning and certain other consequences of external causes (S00-T88)

Section Detail

S40-S49 Injuries to the shoulder and upper arm (S40-S49)

Coding Guidelines & Notes

excludes1

traumatic amputation of shoulder and upper arm (S48.-)

excludes2

periprosthetic fracture around internal prosthetic shoulder joint (M97.3)

sevenChrDef

{'char': 'A', 'text': 'initial encounter for closed fracture'}
{'char': 'B', 'text': 'initial encounter for open fracture'}
{'char': 'D', 'text': 'subsequent encounter for fracture with routine healing'}
{'char': 'G', 'text': 'subsequent encounter for fracture with delayed healing'}
{'char': 'K', 'text': 'subsequent encounter for fracture with nonunion'}
{'char': 'P', 'text': 'subsequent encounter for fracture with malunion'}
{'char': 'S', 'text': 'sequela'}

sevenChrNote

The appropriate 7th character is to be added to all codes from category S42

More Specific Diagnosis Codes

This code is not billable as it requires a higher level of specificity. Select a more specific code below.

S42.0 - Fracture of clavicle
S42.1 - Fracture of scapula
S42.2 - Fracture of upper end of humerus
S42.3 - Fracture of shaft of humerus
S42.4 - Fracture of lower end of humerus
S42.9 - Fracture of shoulder girdle, part unspecified

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