S42.242K: 4-part fracture of surgical neck of left humerus, subsequent encounter for fracture with nonunion
S42.242K is a billable, specific ICD-10-CM code for 4-part fracture of surgical neck of left humerus, subsequent encounter for fracture with nonunion. It is valid for submission on a claim.
Check S42.242K with the rest of the claim: free scrubber7th character "K": subsequent encounter for fracture with nonunion
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 S42.242K
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S42.242K
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 S42.242K
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
S42.242K is named in 4 Medicare coverage policies: 4 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 S42.242
- S42.242A4-part fracture of surgical neck of left humerus, initial encounter for closed fracture
- S42.242B4-part fracture of surgical neck of left humerus, initial encounter for open fracture
- S42.242D4-part fracture of surgical neck of left humerus, subsequent encounter for fracture with routine healing
- S42.242G4-part fracture of surgical neck of left humerus, subsequent encounter for fracture with delayed healing
- S42.242P4-part fracture of surgical neck of left humerus, subsequent encounter for fracture with malunion
- S42.242S4-part fracture of surgical neck of left humerus, sequela