S42.111G
S42.111G: Displaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with delayed healing
Billable / specific codeICD-10-CMPOA exemptright
S42.111G is a billable, specific ICD-10-CM code for displaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with delayed healing. It is valid for submission on a claim.
Check S42.111G with the rest of the claim: free scrubber7th character "G": subsequent encounter for fracture with delayed healing
The appropriate 7th character is to be added to all codes from category S42
- A
- initial encounter for closed fracture
- B
- initial encounter for open fracture
- D
- subsequent encounter for fracture with routine healing
- G
- subsequent encounter for fracture with delayed healing
- K
- subsequent encounter for fracture with nonunion
- P
- subsequent encounter for fracture with malunion
- S
- sequela
Excludes1 inherited from the categories above S42.111G
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S42.111G
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with S42.111G
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
S42.111G is named in 3 Medicare coverage policies: 3 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
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- A53065Billing and Coding: Outpatient Physical Therapy
- A57311Billing and Coding: Physical Therapy - Home Health
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S42.111
- S42.111ADisplaced fracture of body of scapula, right shoulder, initial encounter for closed fracture
- S42.111BDisplaced fracture of body of scapula, right shoulder, initial encounter for open fracture
- S42.111DDisplaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with routine healing
- S42.111KDisplaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with nonunion
- S42.111PDisplaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with malunion
- S42.111SDisplaced fracture of body of scapula, right shoulder, sequela