S42.115
S42.115 — Nondisplaced fracture of body of scapula, left shoulder
Non-billable headerICD-10-CMleft
S42.115 is a non-billable header ICD-10-CM code for nondisplaced fracture of body of scapula, left shoulder. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.
This code requires a 7th character
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
Risk adjustment
S42.115 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead S42.115
7 child codes. Green means billable.
- S42.115ANondisplaced fracture of body of scapula, left shoulder, initial encounter for closed fracture
- S42.115BNondisplaced fracture of body of scapula, left shoulder, initial encounter for open fracture
- S42.115DNondisplaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with routine healing
- S42.115GNondisplaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with delayed healing
- S42.115KNondisplaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with nonunion
- S42.115PNondisplaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with malunion
- S42.115SNondisplaced fracture of body of scapula, left shoulder, sequela
Related codes at this level
Codes that share S42.11. If S42.115 is not quite right, the correct code is usually one of these.
- S42.111Displaced fracture of body of scapula, right shoulder
- S42.112Displaced fracture of body of scapula, left shoulder
- S42.113Displaced fracture of body of scapula, unspecified shoulder
- S42.114Nondisplaced fracture of body of scapula, right shoulder
- S42.116Nondisplaced fracture of body of scapula, unspecified shoulder
Questions about S42.115
- Is S42.115 a billable ICD-10-CM code?
- No. S42.115 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S42.115 sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the shoulder and upper arm (S40-S49).