S42.153P
S42.153P: Displaced fracture of neck of scapula, unspecified shoulder, subsequent encounter for fracture with malunion
Billable / specific codeICD-10-CMPOA exemptunspecified
S42.153P is a billable, specific ICD-10-CM code for displaced fracture of neck of scapula, unspecified shoulder, subsequent encounter for fracture with malunion. It is valid for submission on a claim.
Check S42.153P 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 S42.153P
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S42.153P
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with S42.153P
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
S42.153P is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53065Billing and Coding: Outpatient Physical Therapy
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S42.153
- S42.153ADisplaced fracture of neck of scapula, unspecified shoulder, initial encounter for closed fracture
- S42.153BDisplaced fracture of neck of scapula, unspecified shoulder, initial encounter for open fracture
- S42.153DDisplaced fracture of neck of scapula, unspecified shoulder, subsequent encounter for fracture with routine healing
- S42.153GDisplaced fracture of neck of scapula, unspecified shoulder, subsequent encounter for fracture with delayed healing
- S42.153KDisplaced fracture of neck of scapula, unspecified shoulder, subsequent encounter for fracture with nonunion
- S42.153SDisplaced fracture of neck of scapula, unspecified shoulder, sequela