S42.155
S42.155 — Nondisplaced fracture of neck of scapula, left shoulder
Non-billable headerICD-10-CMleft
S42.155 is a non-billable header ICD-10-CM code for nondisplaced fracture of neck 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
S42.155 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 S42.155
7 child codes. Green means billable.
- S42.155ANondisplaced fracture of neck of scapula, left shoulder, initial encounter for closed fracture
- S42.155BNondisplaced fracture of neck of scapula, left shoulder, initial encounter for open fracture
- S42.155DNondisplaced fracture of neck of scapula, left shoulder, subsequent encounter for fracture with routine healing
- S42.155GNondisplaced fracture of neck of scapula, left shoulder, subsequent encounter for fracture with delayed healing
- S42.155KNondisplaced fracture of neck of scapula, left shoulder, subsequent encounter for fracture with nonunion
- S42.155PNondisplaced fracture of neck of scapula, left shoulder, subsequent encounter for fracture with malunion
- S42.155SNondisplaced fracture of neck of scapula, left shoulder, sequela
Related codes at this level
Codes that share S42.15. If S42.155 is not quite right, the correct code is usually one of these.
- S42.151Displaced fracture of neck of scapula, right shoulder
- S42.152Displaced fracture of neck of scapula, left shoulder
- S42.153Displaced fracture of neck of scapula, unspecified shoulder
- S42.154Nondisplaced fracture of neck of scapula, right shoulder
- S42.156Nondisplaced fracture of neck of scapula, unspecified shoulder
Questions about S42.155
- Is S42.155 a billable ICD-10-CM code?
- No. S42.155 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S42.155 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).