2020 ICD-10-CM Diagnosis Code S42.209P

Unspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with malunion

    2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
  • S42.209P is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • Short description: Unsp fx upper end of unsp humerus, subs for fx w malunion
  • The 2020 edition of ICD-10-CM S42.209P became effective on October 1, 2019.
  • This is the American ICD-10-CM version of S42.209P - other international versions of ICD-10 S42.209P may differ.
The following code(s) above S42.209P 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 S42.209P:
  • 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
  • S42
    ICD-10-CM Diagnosis Code S42

    Fracture of shoulder and upper arm

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    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
    • traumatic amputation of shoulder and upper arm (S48.-)
    Fracture of shoulder and upper arm
  • S42.2
    ICD-10-CM Diagnosis Code S42.2

    Fracture of upper end of humerus

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Applicable To
    • Fracture of proximal end of humerus
    Type 2 Excludes
    • fracture of shaft of humerus (S42.3-)
    • physeal fracture of upper end of humerus (S49.0-)
    Fracture of upper end of humerus
Present On Admission
POA Help
"Present On Admission" is defined as present at the time the order for inpatient admission occurs — conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are considered POA.
  • S42.209P is considered exempt from POA reporting.
ICD-10-CM S42.209P is grouped within Diagnostic Related Group(s) (MS-DRG v37.0):
  • 564 Other musculoskeletal system and connective tissue diagnoses with mcc
  • 565 Other musculoskeletal system and connective tissue diagnoses with cc
  • 566 Other musculoskeletal system and connective tissue diagnoses without cc/mcc

Convert S42.209P to ICD-9-CM

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
ICD-10-CM Codes Adjacent To S42.209P
S42.202G …… subsequent encounter for fracture with delayed healing
S42.202K …… subsequent encounter for fracture with nonunion
S42.202P …… subsequent encounter for fracture with malunion
S42.202S …… sequela
S42.209 Unspecified fracture of upper end of unspecified humerus
S42.209A …… initial encounter for closed fracture
S42.209B …… initial encounter for open fracture
S42.209D …… subsequent encounter for fracture with routine healing
S42.209G …… subsequent encounter for fracture with delayed healing
S42.209K …… subsequent encounter for fracture with nonunion
S42.209P …… subsequent encounter for fracture with malunion
S42.209S …… sequela
S42.21 Unspecified fracture of surgical neck of humerus
S42.211 Unspecified displaced fracture of surgical neck of right humerus
S42.211A …… initial encounter for closed fracture
S42.211B …… initial encounter for open fracture
S42.211D …… subsequent encounter for fracture with routine healing
S42.211G …… subsequent encounter for fracture with delayed healing
S42.211K …… subsequent encounter for fracture with nonunion
S42.211P …… subsequent encounter for fracture with malunion
S42.211S …… sequela

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