S42.23
S42.23 — 3-part fracture of surgical neck of humerus
Non-billable headerICD-10-CM
S42.23 is a non-billable header ICD-10-CM code for 3-part fracture of surgical neck of humerus. 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
S42.23 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 S42.23
3 child codes. Green means billable.
Related codes at this level
Codes that share S42.2. If S42.23 is not quite right, the correct code is usually one of these.
- S42.20Unspecified fracture of upper end of humerus
- S42.21Unspecified fracture of surgical neck of humerus
- S42.222-part fracture of surgical neck of humerus
- S42.244-part fracture of surgical neck of humerus
- S42.25Fracture of greater tuberosity of humerus
- S42.26Fracture of lesser tuberosity of humerus
- S42.27Torus fracture of upper end of humerus
- S42.29Other fracture of upper end of humerus
Questions about S42.23
- Is S42.23 a billable ICD-10-CM code?
- No. S42.23 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S42.23 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).