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ICD-10-CM Codes
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S00-T88
Injury, poisoning and certain other consequences of external causes
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S40-S49
Injuries to the shoulder and upper arm
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S42-
Fracture of shoulder and upper arm
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2021 ICD-10-CM Diagnosis Code S42.494P
2021 ICD-10-CM Diagnosis Code S42.494P
Other nondisplaced fracture of lower end of right humerus, subsequent encounter for fracture with malunion
2016 2017 2018 2019 2020 2021 Billable/Specific Code POA Exempt
- S42.494P is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
- Short description: Oth nondisp fx of lower end r humer, subs for fx w malunion
- The 2021 edition of ICD-10-CM S42.494P became effective on October 1, 2020.
- This is the American ICD-10-CM version of S42.494P - other international versions of ICD-10 S42.494P may differ.
The following code(s) above
S42.494P 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
S42.494P:
- S00-T88
2021 ICD-10-CM Range S00-T88
Injury, poisoning and certain other consequences of external causesNote- 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
Use Additional- code to identify any retained foreign body, if applicable (Z18.-)
- S40-S49
2021 ICD-10-CM Range S40-S49
Injuries to the shoulder and upper armIncludes- injuries of axilla
- injuries of scapular region
- S42
ICD-10-CM Diagnosis Code S42
Fracture of shoulder and upper arm
2016 2017 2018 2019 2020 2021 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.-)
- S42.4
ICD-10-CM Diagnosis Code S42.4
Fracture of lower end of humerus
2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
Applicable To- Fracture of distal end of humerus
Type 2 Excludes- fracture of shaft of humerus (S42.3-)
- physeal fracture of lower end of humerus (S49.1-)
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.
- S42.494P is considered exempt from POA reporting.
ICD-10-CM S42.494P is grouped within Diagnostic Related Group(s) (MS-DRG v38.0):
- 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 S42.494P 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
- 2021 (effective 10/1/2020): No change
ICD-10-CM Codes Adjacent To S42.494P
S42.493G …… subsequent encounter for fracture with delayed healing
S42.493K …… subsequent encounter for fracture with nonunion
S42.493P …… subsequent encounter for fracture with malunion
S42.494 Other nondisplaced fracture of lower end of right humerus
S42.494A …… initial encounter for closed fracture
S42.494B …… initial encounter for open fracture
S42.494D …… subsequent encounter for fracture with routine healing
S42.494G …… subsequent encounter for fracture with delayed healing
S42.494K …… subsequent encounter for fracture with nonunion
S42.494P
…… subsequent encounter for fracture with malunion
S42.495 Other nondisplaced fracture of lower end of left humerus
S42.495A …… initial encounter for closed fracture
S42.495B …… initial encounter for open fracture
S42.495D …… subsequent encounter for fracture with routine healing
S42.495G …… subsequent encounter for fracture with delayed healing
S42.495K …… subsequent encounter for fracture with nonunion
S42.495P …… subsequent encounter for fracture with malunion
S42.496 Other nondisplaced fracture of lower end of unspecified humerus
Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.
