S42.361
S42.361 — Displaced segmental fracture of shaft of humerus, right arm
Non-billable headerICD-10-CMright
S42.361 is a non-billable header ICD-10-CM code for displaced segmental fracture of shaft of humerus, right arm. 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
S42.361 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 S42.361
7 child codes. Green means billable.
- S42.361ADisplaced segmental fracture of shaft of humerus, right arm, initial encounter for closed fracture
- S42.361BDisplaced segmental fracture of shaft of humerus, right arm, initial encounter for open fracture
- S42.361DDisplaced segmental fracture of shaft of humerus, right arm, subsequent encounter for fracture with routine healing
- S42.361GDisplaced segmental fracture of shaft of humerus, right arm, subsequent encounter for fracture with delayed healing
- S42.361KDisplaced segmental fracture of shaft of humerus, right arm, subsequent encounter for fracture with nonunion
- S42.361PDisplaced segmental fracture of shaft of humerus, right arm, subsequent encounter for fracture with malunion
- S42.361SDisplaced segmental fracture of shaft of humerus, right arm, sequela
Related codes at this level
Codes that share S42.36. If S42.361 is not quite right, the correct code is usually one of these.
- S42.362Displaced segmental fracture of shaft of humerus, left arm
- S42.363Displaced segmental fracture of shaft of humerus, unspecified arm
- S42.364Nondisplaced segmental fracture of shaft of humerus, right arm
- S42.365Nondisplaced segmental fracture of shaft of humerus, left arm
- S42.366Nondisplaced segmental fracture of shaft of humerus, unspecified arm
Questions about S42.361
- Is S42.361 a billable ICD-10-CM code?
- No. S42.361 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S42.361 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).