S42.416
S42.416 — Nondisplaced simple supracondylar fracture without intercondylar fracture of unspecified humerus
Non-billable headerICD-10-CM
S42.416 is a non-billable header ICD-10-CM code for nondisplaced simple supracondylar fracture without intercondylar fracture of unspecified 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
Risk adjustment
S42.416 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 S42.416
7 child codes. Green means billable.
- S42.416ANondisplaced simple supracondylar fracture without intercondylar fracture of unspecified humerus, initial encounter for closed fracture
- S42.416BNondisplaced simple supracondylar fracture without intercondylar fracture of unspecified humerus, initial encounter for open fracture
- S42.416DNondisplaced simple supracondylar fracture without intercondylar fracture of unspecified humerus, subsequent encounter for fracture with routine healing
- S42.416GNondisplaced simple supracondylar fracture without intercondylar fracture of unspecified humerus, subsequent encounter for fracture with delayed healing
- S42.416KNondisplaced simple supracondylar fracture without intercondylar fracture of unspecified humerus, subsequent encounter for fracture with nonunion
- S42.416PNondisplaced simple supracondylar fracture without intercondylar fracture of unspecified humerus, subsequent encounter for fracture with malunion
- S42.416SNondisplaced simple supracondylar fracture without intercondylar fracture of unspecified humerus, sequela
Related codes at this level
Codes that share S42.41. If S42.416 is not quite right, the correct code is usually one of these.
- S42.411Displaced simple supracondylar fracture without intercondylar fracture of right humerus
- S42.412Displaced simple supracondylar fracture without intercondylar fracture of left humerus
- S42.413Displaced simple supracondylar fracture without intercondylar fracture of unspecified humerus
- S42.414Nondisplaced simple supracondylar fracture without intercondylar fracture of right humerus
- S42.415Nondisplaced simple supracondylar fracture without intercondylar fracture of left humerus
Questions about S42.416
- Is S42.416 a billable ICD-10-CM code?
- No. S42.416 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S42.416 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).