S42.241B: 4-part fracture of surgical neck of right humerus, initial encounter for open fracture
S42.241B is a billable, specific ICD-10-CM code for 4-part fracture of surgical neck of right humerus, initial encounter for open fracture. It is valid for submission on a claim.
Check S42.241B 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 S42.241B
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S42.241B
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 S42.241B
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
S42.241B is named in 6 Medicare coverage policies: 6 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 S42.241
- S42.241A4-part fracture of surgical neck of right humerus, initial encounter for closed fracture
- S42.241D4-part fracture of surgical neck of right humerus, subsequent encounter for fracture with routine healing
- S42.241G4-part fracture of surgical neck of right humerus, subsequent encounter for fracture with delayed healing
- S42.241K4-part fracture of surgical neck of right humerus, subsequent encounter for fracture with nonunion
- S42.241P4-part fracture of surgical neck of right humerus, subsequent encounter for fracture with malunion
- S42.241S4-part fracture of surgical neck of right humerus, sequela