ICD-10-CM Diagnosis Code (2025)
Official Description for S42
Fracture of shoulder and upper arm
Coding Notes & Guidelines for S42
traumatic amputation of shoulder and upper arm (S48.-)
periprosthetic fracture around internal prosthetic shoulder joint (M97.3)
- fracture of shaft of humerus (S42.3-)
- physeal fracture of upper end of humerus (S49.0-)
- physeal fractures of upper end of humerus (S49.0-)
- physeal fractures of lower end of humerus (S49.1-)
- fracture of shaft of humerus (S42.3-)
- physeal fracture of lower end of humerus (S49.1-)
Displaced fracture of sternal end of clavicle NOS
Fracture of acromial end of clavicle
Fracture of proximal end of humerus
Fracture of neck of humerus NOS
- Fracture of anatomical neck of humerus
- Fracture of articular head of humerus
- Fracture of humerus NOS
- Fracture of upper arm NOS
Fracture of distal end of humerus
Fracture of elbow NOS
Fracture of capitellum of humerus
Trochlea fracture of humerus
Fracture of shoulder NOS
The appropriate 7th character is to be added to all codes from category S42
The appropriate 7th character is to be added to all codes in subcategory S42.27
The appropriate 7th character is to be added to all codes in subcategory S42.31
The appropriate 7th character is to be added to all codes in subcategory S42.48
- A: initial encounter for closed fracture
- B: initial encounter for open fracture
- D: subsequent encounter for fracture with routine healing
- G: subsequent encounter for fracture with delayed healing
- K: subsequent encounter for fracture with nonunion
- P: subsequent encounter for fracture with malunion
- S: sequela
Child Codes (More Specific Codes for S42):
About ICD-10-CM Code S42 (Fracture of shoulder and upper arm)
ICD-10-CM code S42 is a billable or specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2025 edition of ICD-10-CM S42 became effective on October 1, 2024.
This page provides detailed information about S42 - Fracture of shoulder and upper arm. It includes common terminology, coding guidelines such as "Includes," "Excludes1," and "Excludes2" notes, and information on required 7th characters. Utilizing this information correctly is essential for accurate medical coding and claims submission for conditions like Fracture of shoulder and upper arm.