S42.3: Fracture of shaft of humerus
S42.3 is a non-billable header ICD-10-CM code for fracture of shaft 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
Excludes2: not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Fracture of humerus NOS
- Fracture of upper arm NOS
Excludes1 inherited from the categories above S42.3
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S42.3
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with S42.3
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 S42.3
8 child codes. Green means billable.
- S42.30Unspecified fracture of shaft of humerus
- S42.31Greenstick fracture of shaft of humerus
- S42.32Transverse fracture of shaft of humerus
- S42.33Oblique fracture of shaft of humerus
- S42.34Spiral fracture of shaft of humerus
- S42.35Comminuted fracture of shaft of humerus
- S42.36Segmental fracture of shaft of humerus
- S42.39Other fracture of shaft of humerus