S42.212B: Unspecified displaced fracture of surgical neck of left humerus, initial encounter for open fracture
S42.212B is a billable, specific ICD-10-CM code for unspecified displaced fracture of surgical neck of left humerus, initial encounter for open fracture. It is valid for submission on a claim.
Check S42.212B 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 S42.212B
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S42.212B
Not part of this code, but both may be coded when both are present.
Written on S42.2: Fracture of upper end of humerus
Other codes that can never be billed with S42.212B
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
S42.212B is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
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Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S42.212
- S42.212AUnspecified displaced fracture of surgical neck of left humerus, initial encounter for closed fracture
- S42.212DUnspecified displaced fracture of surgical neck of left humerus, subsequent encounter for fracture with routine healing
- S42.212GUnspecified displaced fracture of surgical neck of left humerus, subsequent encounter for fracture with delayed healing
- S42.212KUnspecified displaced fracture of surgical neck of left humerus, subsequent encounter for fracture with nonunion
- S42.212PUnspecified displaced fracture of surgical neck of left humerus, subsequent encounter for fracture with malunion
- S42.212SUnspecified displaced fracture of surgical neck of left humerus, sequela