S42.154A
S42.154A: Nondisplaced fracture of neck of scapula, right shoulder, initial encounter for closed fracture
Billable / specific codeICD-10-CMright
S42.154A is a billable, specific ICD-10-CM code for nondisplaced fracture of neck of scapula, right shoulder, initial encounter for closed fracture. It is valid for submission on a claim.
Check S42.154A with the rest of the claim: free scrubber7th character "A": initial encounter for closed fracture
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 S42.154A
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S42.154A
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with S42.154A
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
S42.154A is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A57311Billing and Coding: Physical Therapy - Home Health
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S42.154
- S42.154BNondisplaced fracture of neck of scapula, right shoulder, initial encounter for open fracture
- S42.154DNondisplaced fracture of neck of scapula, right shoulder, subsequent encounter for fracture with routine healing
- S42.154GNondisplaced fracture of neck of scapula, right shoulder, subsequent encounter for fracture with delayed healing
- S42.154KNondisplaced fracture of neck of scapula, right shoulder, subsequent encounter for fracture with nonunion
- S42.154PNondisplaced fracture of neck of scapula, right shoulder, subsequent encounter for fracture with malunion
- S42.154SNondisplaced fracture of neck of scapula, right shoulder, sequela