S42.192B
S42.192B: Fracture of other part of scapula, left shoulder, initial encounter for open fracture
Billable / specific codeICD-10-CMleft
S42.192B is a billable, specific ICD-10-CM code for fracture of other part of scapula, left shoulder, initial encounter for open fracture. It is valid for submission on a claim.
Check S42.192B with the rest of the claim: free scrubber7th character "B": initial encounter for open 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 S42.192B
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S42.192B
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with S42.192B
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
S42.192B is named in 5 Medicare coverage policies: 5 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines
- A56900Billing and Coding: Immunizations
- A57311Billing and Coding: Physical Therapy - Home Health
- A58872Billing and Coding: Tetanus Immunization
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S42.192
- S42.192AFracture of other part of scapula, left shoulder, initial encounter for closed fracture
- S42.192DFracture of other part of scapula, left shoulder, subsequent encounter for fracture with routine healing
- S42.192GFracture of other part of scapula, left shoulder, subsequent encounter for fracture with delayed healing
- S42.192KFracture of other part of scapula, left shoulder, subsequent encounter for fracture with nonunion
- S42.192PFracture of other part of scapula, left shoulder, subsequent encounter for fracture with malunion
- S42.192SFracture of other part of scapula, left shoulder, sequela