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S42.216Non-billableSave

S42.216 - Unspecified nondisplaced fracture of surgical neck of unspecified humerus

ICD-10-CM Chapter 19: Injury, poisoning and certain other consequences of external causes · S40-S49 Injuries to the shoulder and upper arm (S40-S49) · Subcategory of S42.21 · FY2027

Coding Guidance

S42.216 requires a 7th character. Report the code below that matches the documentation, for example A for initial encounter for closed fracture, B for initial encounter for open fracture, D for subsequent encounter for fracture with routine healing.

7th Character

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

Includes, Excludes and Coding Notes

Excludes 2 — Not Included HereFrom S42.2

Not part of this code; report both codes when the patient has both conditions.

  • fracture of shaft of humerus (S42.3-)
  • physeal fracture of upper end of humerus (S49.0-)
Excludes 1 — Not Coded HereFrom S42

Mutually exclusive: these conditions are never reported together with this code.

  • traumatic amputation of shoulder and upper arm (S48.-)
Excludes 2 — Not Included HereFrom S42

Not part of this code; report both codes when the patient has both conditions.

  • periprosthetic fracture around internal prosthetic shoulder joint (M97.3)
NotesFrom S42

Instructional notes from the ICD-10-CM tabular list.

  • 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
IncludesFrom S40-S49 Injuries to the shoulder and upper arm (S40-S49)

Conditions this code covers.

  • injuries of axilla
  • injuries of scapular region
Excludes 2 — Not Included HereFrom S40-S49 Injuries to the shoulder and upper arm (S40-S49)

Not part of this code; report both codes when the patient has both conditions.

  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • injuries of elbow (S50-S59)
  • insect bite or sting, venomous (T63.4)
Excludes 2 — Not Included HereFrom Chapter S00-T88

Not part of this code; report both codes when the patient has both conditions.

  • birth trauma (P10-P15)
  • obstetric trauma (O70-O71)
Use Additional CodeFrom Chapter S00-T88

Add a secondary code to identify the associated condition or cause when it is documented.

  • code to identify any retained foreign body, if applicable (Z18.-)
NotesFrom Chapter S00-T88

Instructional notes from the ICD-10-CM tabular list.

  • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
  • The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.

More Specific Codes (7)

S42.216AUnspecified nondisplaced fracture of surgical neck of unspecified humerus, initial encounter for closed fracture→S42.216BUnspecified nondisplaced fracture of surgical neck of unspecified humerus, initial encounter for open fracture→S42.216DUnspecified nondisplaced fracture of surgical neck of unspecified humerus, subsequent encounter for fracture with routine healing→S42.216GUnspecified nondisplaced fracture of surgical neck of unspecified humerus, subsequent encounter for fracture with delayed healing→S42.216KUnspecified nondisplaced fracture of surgical neck of unspecified humerus, subsequent encounter for fracture with nonunion→S42.216PUnspecified nondisplaced fracture of surgical neck of unspecified humerus, subsequent encounter for fracture with malunion→S42.216SUnspecified nondisplaced fracture of surgical neck of unspecified humerus, sequela→

Related condition guides

Documentation requirements, coding pitfalls and FAQs for conditions coded with S42.216.