S42.265
S42.265 — Nondisplaced fracture of lesser tuberosity of left humerus
Non-billable headerICD-10-CMleft
S42.265 is a non-billable header ICD-10-CM code for nondisplaced fracture of lesser tuberosity of left 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
S42.265 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 S42.265
7 child codes. Green means billable.
- S42.265ANondisplaced fracture of lesser tuberosity of left humerus, initial encounter for closed fracture
- S42.265BNondisplaced fracture of lesser tuberosity of left humerus, initial encounter for open fracture
- S42.265DNondisplaced fracture of lesser tuberosity of left humerus, subsequent encounter for fracture with routine healing
- S42.265GNondisplaced fracture of lesser tuberosity of left humerus, subsequent encounter for fracture with delayed healing
- S42.265KNondisplaced fracture of lesser tuberosity of left humerus, subsequent encounter for fracture with nonunion
- S42.265PNondisplaced fracture of lesser tuberosity of left humerus, subsequent encounter for fracture with malunion
- S42.265SNondisplaced fracture of lesser tuberosity of left humerus, sequela
Related codes at this level
Codes that share S42.26. If S42.265 is not quite right, the correct code is usually one of these.
- 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
- S42.264Nondisplaced fracture of lesser tuberosity of right humerus
- S42.266Nondisplaced fracture of lesser tuberosity of unspecified humerus
Questions about S42.265
- Is S42.265 a billable ICD-10-CM code?
- No. S42.265 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S42.265 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).