S42.261
S42.261 — Displaced fracture of lesser tuberosity of right humerus
Non-billable headerICD-10-CMright
S42.261 is a non-billable header ICD-10-CM code for displaced fracture of lesser tuberosity of right 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
S42.261 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 S42.261
7 child codes. Green means billable.
- S42.261ADisplaced fracture of lesser tuberosity of right humerus, initial encounter for closed fracture
- S42.261BDisplaced fracture of lesser tuberosity of right humerus, initial encounter for open fracture
- S42.261DDisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with routine healing
- S42.261GDisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with delayed healing
- S42.261KDisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with nonunion
- S42.261PDisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with malunion
- S42.261SDisplaced fracture of lesser tuberosity of right humerus, sequela
Related codes at this level
Codes that share S42.26. If S42.261 is not quite right, the correct code is usually one of these.
- S42.262Displaced fracture of lesser tuberosity of left humerus
- S42.263Displaced fracture of lesser tuberosity of unspecified humerus
- S42.264Nondisplaced fracture of lesser tuberosity of right humerus
- S42.265Nondisplaced fracture of lesser tuberosity of left humerus
- S42.266Nondisplaced fracture of lesser tuberosity of unspecified humerus
Questions about S42.261
- Is S42.261 a billable ICD-10-CM code?
- No. S42.261 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S42.261 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).