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S42.249Non-billableSave

S42.249 - 4-part 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 S42.24 · FY2027

Coding Guidance

S42.249 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)

S42.249A4-part fracture of surgical neck of unspecified humerus, initial encounter for closed fracture→S42.249B4-part fracture of surgical neck of unspecified humerus, initial encounter for open fracture→S42.249D4-part fracture of surgical neck of unspecified humerus, subsequent encounter for fracture with routine healing→S42.249G4-part fracture of surgical neck of unspecified humerus, subsequent encounter for fracture with delayed healing→S42.249K4-part fracture of surgical neck of unspecified humerus, subsequent encounter for fracture with nonunion→S42.249P4-part fracture of surgical neck of unspecified humerus, subsequent encounter for fracture with malunion→S42.249S4-part fracture of surgical neck of unspecified humerus, sequela→

Related condition guides

Documentation requirements, coding pitfalls and FAQs for conditions coded with S42.249.