S42.29
S42.29 — Other fracture of upper end of humerus
Non-billable headerICD-10-CM
S42.29 is a non-billable header ICD-10-CM code for other fracture of upper end of 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
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Fracture of anatomical neck of humerus
- Fracture of articular head of humerus
Risk adjustment
S42.29 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 S42.29
6 child codes. Green means billable.
- S42.291Other displaced fracture of upper end of right humerus
- S42.292Other displaced fracture of upper end of left humerus
- S42.293Other displaced fracture of upper end of unspecified humerus
- S42.294Other nondisplaced fracture of upper end of right humerus
- S42.295Other nondisplaced fracture of upper end of left humerus
- S42.296Other nondisplaced fracture of upper end of unspecified humerus
Related codes at this level
Codes that share S42.2. If S42.29 is not quite right, the correct code is usually one of these.
- S42.20Unspecified fracture of upper end of humerus
- S42.21Unspecified fracture of surgical neck of humerus
- S42.222-part fracture of surgical neck of humerus
- S42.233-part fracture of surgical neck of humerus
- S42.244-part fracture of surgical neck of humerus
- S42.25Fracture of greater tuberosity of humerus
- S42.26Fracture of lesser tuberosity of humerus
- S42.27Torus fracture of upper end of humerus
Questions about S42.29
- Is S42.29 a billable ICD-10-CM code?
- No. S42.29 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S42.29 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).