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ICD-10-CM Codes
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S00-T88
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S40-S49
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S42-
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2023 ICD-10-CM Diagnosis Code S42
2023 ICD-10-CM Diagnosis Code S42
Fracture of shoulder and upper arm
2016 2017 2018 2019 2020 2021 2022 2023 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 2023 edition of ICD-10-CM S42 became effective on October 1, 2022.
- 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 ExcludesType 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.
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:
- 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
- 2021 (effective 10/1/2020): No change
- 2022 (effective 10/1/2021): No change
- 2023 (effective 10/1/2022): No change
Code annotations containing back-references to S42:
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Type 1 Excludes: M84.3, M84.4
ICD-10-CM Diagnosis Code M84.3
Stress fracture
2016 2017 2018 2019 2020 2021 2022 2023 Non-Billable/Non-Specific Code
Applicable To- Fatigue fracture
- March fracture
- Stress fracture NOS
- Stress reaction
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 2021 2022 2023 Non-Billable/Non-Specific Code
Applicable To- Chronic fracture
- Pathological fracture NOS
Type 2 Excludes- personal history of (healed) pathological fracture (Z87.311)
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Type 2 Excludes: S41
ICD-10-CM Diagnosis Code S41
Open wound of shoulder and upper arm
2016 2017 2018 2019 2020 2021 2022 2023 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
S41.152 Open bite of left upper arm
S41.159 Open bite of unspecified upper arm
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
Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.
