2020 ICD-10-CM Diagnosis Code S42

Fracture of shoulder and upper arm

    2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
  • S42 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
  • The 2020 edition of ICD-10-CM S42 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of S42 - other international versions of ICD-10 S42 may differ.
Note
  • A fracture not indicated as displaced or nondisplaced should be coded to displaced
  • A fracture not indicated as open or closed should be coded to closed
Type 1 Excludes
Type 1 Excludes Help
A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as S42. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • traumatic amputation of shoulder and upper arm (
    ICD-10-CM Diagnosis Code S48
    • S48 Traumatic amputation of shoulder and upper ar...
      • S48.0 Traumatic amputation at shoulder joint
        • S48.01 Complete traumatic amputation at shoulder joi...
          • S48.011 Complete traumatic amputation at right should...
            • S48.011A Complete traumatic amputation at right should...
            • S48.011D Complete traumatic amputation at right should...
            • S48.011S Complete traumatic amputation at right should...
          • S48.012 Complete traumatic amputation at left shoulde...
            • S48.012A Complete traumatic amputation at left shoulde...
            • S48.012D Complete traumatic amputation at left shoulde...
            • S48.012S Complete traumatic amputation at left shoulde...
          • S48.019 Complete traumatic amputation at unspecified ...
            • S48.019A Complete traumatic amputation at unspecified ...
            • S48.019D Complete traumatic amputation at unspecified ...
            • S48.019S Complete traumatic amputation at unspecified ...
        • S48.02 Partial traumatic amputation at shoulder join...
          • S48.021 Partial traumatic amputation at right shoulde...
            • S48.021A Partial traumatic amputation at right shoulde...
            • S48.021D Partial traumatic amputation at right shoulde...
            • S48.021S Partial traumatic amputation at right shoulde...
          • S48.022 Partial traumatic amputation at left shoulder...
            • S48.022A Partial traumatic amputation at left shoulder...
            • S48.022D Partial traumatic amputation at left shoulder...
            • S48.022S Partial traumatic amputation at left shoulder...
          • S48.029 Partial traumatic amputation at unspecified s...
            • S48.029A Partial traumatic amputation at unspecified s...
            • S48.029D Partial traumatic amputation at unspecified s...
            • S48.029S Partial traumatic amputation at unspecified s...
      • S48.1 Traumatic amputation at level between shoulde...
        • S48.11 Complete traumatic amputation at level betwee...
          • S48.111 Complete traumatic amputation at level betwee...
            • S48.111A Complete traumatic amputation at level betwee...
            • S48.111D Complete traumatic amputation at level betwee...
            • S48.111S Complete traumatic amputation at level betwee...
          • S48.112 Complete traumatic amputation at level betwee...
            • S48.112A Complete traumatic amputation at level betwee...
            • S48.112D Complete traumatic amputation at level betwee...
            • S48.112S Complete traumatic amputation at level betwee...
          • S48.119 Complete traumatic amputation at level betwee...
            • S48.119A Complete traumatic amputation at level betwee...
            • S48.119D Complete traumatic amputation at level betwee...
            • S48.119S Complete traumatic amputation at level betwee...
        • S48.12 Partial traumatic amputation at level between...
          • S48.121 Partial traumatic amputation at level between...
            • S48.121A Partial traumatic amputation at level between...
            • S48.121D Partial traumatic amputation at level between...
            • S48.121S Partial traumatic amputation at level between...
          • S48.122 Partial traumatic amputation at level between...
            • S48.122A Partial traumatic amputation at level between...
            • S48.122D Partial traumatic amputation at level between...
            • S48.122S Partial traumatic amputation at level between...
          • S48.129 Partial traumatic amputation at level between...
            • S48.129A Partial traumatic amputation at level between...
            • S48.129D Partial traumatic amputation at level between...
            • S48.129S Partial traumatic amputation at level between...
      • S48.9 Traumatic amputation of shoulder and upper ar...
        • S48.91 Complete traumatic amputation of shoulder and...
          • S48.911 Complete traumatic amputation of right should...
            • S48.911A Complete traumatic amputation of right should...
            • S48.911D Complete traumatic amputation of right should...
            • S48.911S Complete traumatic amputation of right should...
          • S48.912 Complete traumatic amputation of left shoulde...
            • S48.912A Complete traumatic amputation of left shoulde...
            • S48.912D Complete traumatic amputation of left shoulde...
            • S48.912S Complete traumatic amputation of left shoulde...
          • S48.919 Complete traumatic amputation of unspecified ...
            • S48.919A Complete traumatic amputation of unspecified ...
            • S48.919D Complete traumatic amputation of unspecified ...
            • S48.919S Complete traumatic amputation of unspecified ...
        • S48.92 Partial traumatic amputation of shoulder and ...
          • S48.921 Partial traumatic amputation of right shoulde...
            • S48.921A Partial traumatic amputation of right shoulde...
            • S48.921D Partial traumatic amputation of right shoulde...
            • S48.921S Partial traumatic amputation of right shoulde...
          • S48.922 Partial traumatic amputation of left shoulder...
            • S48.922A Partial traumatic amputation of left shoulder...
            • S48.922D Partial traumatic amputation of left shoulder...
            • S48.922S Partial traumatic amputation of left shoulder...
          • S48.929 Partial traumatic amputation of unspecified s...
            • S48.929A Partial traumatic amputation of unspecified s...
            • S48.929D Partial traumatic amputation of unspecified s...
            • S48.929S Partial traumatic amputation of unspecified s...
    S48.-
    )
The following code(s) above S42 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to S42:
  • S00-T88
    2020 ICD-10-CM Range S00-T88

    Injury, poisoning and certain other consequences of external causes

    Note
    • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
    Type 1 Excludes
    Use Additional
    • code to identify any retained foreign body, if applicable (Z18.-)
    Injury, poisoning and certain other consequences of external causes
  • S40-S49
    2020 ICD-10-CM Range S40-S49

    Injuries to the shoulder and upper arm

    Includes
    • injuries of axilla
    • injuries of scapular region
    Type 2 Excludes
    Injuries to the shoulder and upper arm
Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
Code annotations containing back-references to S42:
  • Type 1 Excludes: M84.3
    , M84.4
    ICD-10-CM Diagnosis Code M84.3

    Stress fracture

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Applicable To
    • Fatigue fracture
    • March fracture
    • Stress fracture NOS
    • Stress reaction
    Type 1 Excludes
    Type 2 Excludes
    • personal history of (healed) stress (fatigue) fracture (Z87.312)
    • stress fracture of vertebra (M48.4-)
    Use Additional
    • external cause code(s) to identify the cause of the stress fracture
    ICD-10-CM Diagnosis Code M84.4

    Pathological fracture, not elsewhere classified

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Applicable To
    • Chronic fracture
    • Pathological fracture NOS
    Type 1 Excludes
    Type 2 Excludes
    • personal history of (healed) pathological fracture (Z87.311)
  • Type 2 Excludes: S41
    ICD-10-CM Diagnosis Code S41

    Open wound of shoulder and upper arm

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Code Also
    • any associated wound infection
    Type 1 Excludes
    • traumatic amputation of shoulder and upper arm (S48.-)
    Type 2 Excludes
    • open fracture of shoulder and upper arm (S42.- with 7th character B or C)
ICD-10-CM Codes Adjacent To S42
S41.151D …… subsequent encounter
S41.151S …… sequela
S41.152 Open bite of left upper arm
S41.152A …… initial encounter
S41.152D …… subsequent encounter
S41.152S …… sequela
S41.159 Open bite of unspecified upper arm
S41.159A …… initial encounter
S41.159D …… subsequent encounter
S41.159S …… sequela
S42 Fracture of shoulder and upper arm
S42.0 Fracture of clavicle
S42.00 Fracture of unspecified part of clavicle
S42.001 Fracture of unspecified part of right clavicle
S42.001A …… initial encounter for closed fracture
S42.001B …… initial encounter for open fracture
S42.001D …… subsequent encounter for fracture with routine healing
S42.001G …… subsequent encounter for fracture with delayed healing
S42.001K …… subsequent encounter for fracture with nonunion
S42.001P …… subsequent encounter for fracture with malunion
S42.001S …… sequela

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.