Fracture of shoulder and upper arm

Not billableICD-10-CM diagnosis code.

This code exists but cannot be submitted on its own. It groups the more specific codes beneath it.

A category header for its whole life, FY2016 onwards. It has never been valid for submission on its own.

Submit one of these 6 more specific codes instead:

S42.0 Fracture of clavicle (also a header)
S42.1 Fracture of scapula (also a header)
S42.2 Fracture of upper end of humerus (also a header)
S42.3 Fracture of shaft of humerus (also a header)
S42.4 Fracture of lower end of humerus (also a header)
S42.9 Fracture of shoulder girdle, part unspecified (also a header)

This code requires a seventh character. See the rule below.

What has happened to this code

Every change the publisher made, from 2012 to now. Entries marked draft are from the pre-implementation releases: ICD-10 took effect on 1 October 2015, so nothing before FY2016 was ever valid on a claim.

FY2012 Added to the draft code set draft Fracture of shoulder and upper arm

Official coding rules

Published by CDC for FY2027. A rule attached to a category binds every code beneath it, so the rules inherited from this code's ancestors are shown with the code they come from.

This code

Seventh character required

The appropriate 7th character is to be added to all codes from category S42

Excludes1 - never coded here

traumatic amputation of shoulder and upper arm (S48.-)

Excludes2 - not included here

periprosthetic fracture around internal prosthetic shoulder joint (M97.3)

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

Inherited from the S40-S49 section Injuries to the shoulder and upper arm (S40-S49)

Excludes2 - not included here

burns and corrosions (T20-T32)
frostbite (T33-T34)
injuries of elbow (S50-S59)
insect bite or sting, venomous (T63.4)

Includes

injuries of axilla
injuries of scapular region