S42.363G: Displaced segmental fracture of shaft of humerus, unspecified arm, subsequent encounter for fracture with delayed healing
S42.363G is a billable, specific ICD-10-CM code for displaced segmental fracture of shaft of humerus, unspecified arm, subsequent encounter for fracture with delayed healing. It is valid for submission on a claim.
Check S42.363G with the rest of the claim: free scrubber7th character "G": subsequent encounter for fracture with delayed healing
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 S42.363G
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S42.363G
Not part of this code, but both may be coded when both are present.
Written on S42.3: Fracture of shaft of humerus
Other codes that can never be billed with S42.363G
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.
Medicare coverage
S42.363G is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53065Billing and Coding: Outpatient Physical Therapy
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S42.363
- S42.363ADisplaced segmental fracture of shaft of humerus, unspecified arm, initial encounter for closed fracture
- S42.363BDisplaced segmental fracture of shaft of humerus, unspecified arm, initial encounter for open fracture
- S42.363DDisplaced segmental fracture of shaft of humerus, unspecified arm, subsequent encounter for fracture with routine healing
- S42.363KDisplaced segmental fracture of shaft of humerus, unspecified arm, subsequent encounter for fracture with nonunion
- S42.363PDisplaced segmental fracture of shaft of humerus, unspecified arm, subsequent encounter for fracture with malunion
- S42.363SDisplaced segmental fracture of shaft of humerus, unspecified arm, sequela