ICD-10-CM › S00-T88 › S40-S49 › S42 Fracture of shoulder and upper arm › S42.1

S42.1

Fracture of scapula

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 7 more specific codes instead:

  • S42.10 Fracture of unspecified part of scapula (also a header)
  • S42.11 Fracture of body of scapula (also a header)
  • S42.12 Fracture of acromial process (also a header)
  • S42.13 Fracture of coracoid process (also a header)
  • S42.14 Fracture of glenoid cavity of scapula (also a header)
  • S42.15 Fracture of neck of scapula (also a header)
  • S42.19 Fracture of other part of scapula (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.

  1. FY2012 Added to the draft code set draft Fracture of scapula

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.

Inherited from S42 Fracture of shoulder and upper arm

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

Codes in the same group

CodeDescriptionStatus
S42.0 Fracture of clavicle Not billable
S42.2 Fracture of upper end of humerus Not billable
S42.3 Fracture of shaft of humerus Not billable
S42.4 Fracture of lower end of humerus Not billable
S42.9 Fracture of shoulder girdle, part unspecified Not billable