S42.366
S42.366 — Nondisplaced segmental fracture of shaft of humerus, unspecified arm
Non-billable headerICD-10-CMunspecified
S42.366 is a non-billable header ICD-10-CM code for nondisplaced segmental fracture of shaft of humerus, unspecified 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
S42.366 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 S42.366
7 child codes. Green means billable.
- S42.366ANondisplaced segmental fracture of shaft of humerus, unspecified arm, initial encounter for closed fracture
- S42.366BNondisplaced segmental fracture of shaft of humerus, unspecified arm, initial encounter for open fracture
- S42.366DNondisplaced segmental fracture of shaft of humerus, unspecified arm, subsequent encounter for fracture with routine healing
- S42.366GNondisplaced segmental fracture of shaft of humerus, unspecified arm, subsequent encounter for fracture with delayed healing
- S42.366KNondisplaced segmental fracture of shaft of humerus, unspecified arm, subsequent encounter for fracture with nonunion
- S42.366PNondisplaced segmental fracture of shaft of humerus, unspecified arm, subsequent encounter for fracture with malunion
- S42.366SNondisplaced segmental fracture of shaft of humerus, unspecified arm, sequela
Related codes at this level
Codes that share S42.36. If S42.366 is not quite right, the correct code is usually one of these.
- S42.361Displaced segmental fracture of shaft of humerus, right arm
- 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
Questions about S42.366
- Is S42.366 a billable ICD-10-CM code?
- No. S42.366 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S42.366 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).