S42.436
S42.436 — Nondisplaced fracture (avulsion) of lateral epicondyle of unspecified humerus
Non-billable headerICD-10-CM
S42.436 is a non-billable header ICD-10-CM code for nondisplaced fracture (avulsion) of lateral epicondyle 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
S42.436 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 S42.436
7 child codes. Green means billable.
- S42.436ANondisplaced fracture (avulsion) of lateral epicondyle of unspecified humerus, initial encounter for closed fracture
- S42.436BNondisplaced fracture (avulsion) of lateral epicondyle of unspecified humerus, initial encounter for open fracture
- S42.436DNondisplaced fracture (avulsion) of lateral epicondyle of unspecified humerus, subsequent encounter for fracture with routine healing
- S42.436GNondisplaced fracture (avulsion) of lateral epicondyle of unspecified humerus, subsequent encounter for fracture with delayed healing
- S42.436KNondisplaced fracture (avulsion) of lateral epicondyle of unspecified humerus, subsequent encounter for fracture with nonunion
- S42.436PNondisplaced fracture (avulsion) of lateral epicondyle of unspecified humerus, subsequent encounter for fracture with malunion
- S42.436SNondisplaced fracture (avulsion) of lateral epicondyle of unspecified humerus, sequela
Related codes at this level
Codes that share S42.43. If S42.436 is not quite right, the correct code is usually one of these.
- S42.431Displaced fracture (avulsion) of lateral epicondyle of right humerus
- S42.432Displaced fracture (avulsion) of lateral epicondyle of left humerus
- S42.433Displaced fracture (avulsion) of lateral epicondyle of unspecified humerus
- S42.434Nondisplaced fracture (avulsion) of lateral epicondyle of right humerus
- S42.435Nondisplaced fracture (avulsion) of lateral epicondyle of left humerus
Questions about S42.436
- Is S42.436 a billable ICD-10-CM code?
- No. S42.436 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S42.436 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).