Unspecified fracture of upper end of unspecified humerus

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:

S42.209A Unspecified fracture of upper end of unspecified humerus, initial encounter for closed fracture
S42.209B Unspecified fracture of upper end of unspecified humerus, initial encounter for open fracture
S42.209D Unspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with routine healing
S42.209G Unspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with delayed healing
S42.209K Unspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with nonunion
S42.209P Unspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with malunion
S42.209S Unspecified fracture of upper end of unspecified humerus, sequela

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

What has happened to this code

Every change the publisher made, from 2014 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.

FY2014 Added to the draft code set draft Unspecified fracture of upper end of unspecified humerus

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

How CDC's index refers to this code

Wording from the official alphabetic index. Much of it appears nowhere in the code description, which is why a search for the everyday phrase so often finds nothing.

Fracture, traumatic > humerus > tuberosity
Fracture, traumatic > humerus > proximal end
Fracture, traumatic > humerus > anatomical neck
Fracture, traumatic > humerus > upper end

Codes in the same group

Code	Description	Status
S42.201	Unspecified fracture of upper end of right humerus	Not billable
S42.202	Unspecified fracture of upper end of left humerus	Not billable