S42.131P
S42.131P: Displaced fracture of coracoid process, right shoulder, subsequent encounter for fracture with malunion
Billable / specific codeICD-10-CMPOA exemptright
S42.131P is a billable, specific ICD-10-CM code for displaced fracture of coracoid process, right shoulder, subsequent encounter for fracture with malunion. It is valid for submission on a claim.
Check S42.131P with the rest of the claim: free scrubber7th character "P": subsequent encounter for fracture with malunion
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 S42.131P
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S42.131P
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with S42.131P
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
S42.131P is named in 3 Medicare coverage policies: 3 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53058Billing and Coding: Home Health Physical Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
- A59878Billing and Coding: Total Shoulder Arthroplasty
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S42.131
- S42.131ADisplaced fracture of coracoid process, right shoulder, initial encounter for closed fracture
- S42.131BDisplaced fracture of coracoid process, right shoulder, initial encounter for open fracture
- S42.131DDisplaced fracture of coracoid process, right shoulder, subsequent encounter for fracture with routine healing
- S42.131GDisplaced fracture of coracoid process, right shoulder, subsequent encounter for fracture with delayed healing
- S42.131KDisplaced fracture of coracoid process, right shoulder, subsequent encounter for fracture with nonunion
- S42.131SDisplaced fracture of coracoid process, right shoulder, sequela