Question 1

Is S42 a billable ICD-10 code?

Accepted Answer

No, S42 is not a billable code. It is a category code that requires additional specificity. You must select a more specific code from the subcategories for billing purposes.

Question 2

What does ICD-10 code S42 mean?

Accepted Answer

ICD-10-CM code S42 represents Fracture of shoulder and upper arm. This code is part of the International Classification of Diseases, 10th Revision, Clinical Modification used for medical coding and billing in the United States.

Question 3

When was ICD-10 code S42 introduced?

Accepted Answer

Code S42 has been part of ICD-10-CM since 2016, when the coding system was mandated for use in the United States. This code was included in the original US implementation.

Question 4

What is the parent category for ICD-10 code S42?

Accepted Answer

The parent category for S42 is section:S40-S49 (Injuries to the shoulder and upper arm (S40-S49)). This hierarchical classification helps organize related diagnoses for more accurate coding.

Question 5

What conditions are excluded from S42?

Accepted Answer

Code S42 has Type 1 Excludes (mutually exclusive conditions) including: traumatic amputation of shoulder and upper arm (S48.-). These conditions cannot be coded together with S42 as they represent different diagnoses.

Question 6

Does S42 require a 7th character extension?

Accepted Answer

Yes, S42 requires a 7th character to specify the encounter type. Available extensions include: A (initial encounter for closed fracture), B (initial encounter for open fracture), D (subsequent encounter for fracture with routine healing) and 4 more options. Use "X" as a placeholder to fill empty positions before the 7th character (e.g., S42XXA for initial encounter). The extension indicates whether this is an initial visit, follow-up, or treatment for a late effect.

S422026

Excludes11Not coded together

Excludes27Not included here

Use Additional Code1Add code for detail

Notes4Additional information

Includes2Included conditions

7th Character Extensions7Fracture encounter types

Excluded By3Codes that exclude this one