S42.264
S42.264: Nondisplaced fracture of lesser tuberosity of right humerus
Non-billable headerICD-10-CMright
S42.264 is a non-billable header ICD-10-CM code for nondisplaced 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
Excludes1 inherited from the categories above S42.264
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S42.264
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 S42.264
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.
Code history
Unchanged in every release from FY2024 to FY2027.
Code to one of these instead S42.264
7 child codes. Green means billable.
- S42.264ANondisplaced fracture of lesser tuberosity of right humerus, initial encounter for closed fracture
- S42.264BNondisplaced fracture of lesser tuberosity of right humerus, initial encounter for open fracture
- S42.264DNondisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with routine healing
- S42.264GNondisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with delayed healing
- S42.264KNondisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with nonunion
- S42.264PNondisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with malunion
- S42.264SNondisplaced fracture of lesser tuberosity of right humerus, sequela
Other codes under S42.26
- S42.261Displaced fracture of lesser tuberosity of right humerus
- S42.262Displaced fracture of lesser tuberosity of left humerus
- S42.263Displaced fracture of lesser tuberosity of unspecified humerus
- S42.265Nondisplaced fracture of lesser tuberosity of left humerus
- S42.266Nondisplaced fracture of lesser tuberosity of unspecified humerus