Is S42.482A a billable ICD-10-CM code?

Yes. S42.482A is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S42.482A 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).

S42.482A

S42.482A — Torus fracture of lower end of left humerus, initial encounter for closed fracture

Billable / specific codeICD-10-CMleft

S42.482A is a billable, specific ICD-10-CM code for torus fracture of lower end of left humerus, initial encounter for closed fracture. It is valid for submission on a claim.

7th character "A" — initial encounter for closed fracture

The appropriate 7th character is to be added to all codes in subcategory S42.48

A: initial encounter for closed 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

S42.482A 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.

Medicare coverage

S42.482A is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57311Billing and Coding: Physical Therapy - Home Health

Related codes at this level

Codes that share S42.482. If S42.482A is not quite right, the correct code is usually one of these.

Questions about S42.482A

Is S42.482A a billable ICD-10-CM code?: Yes. S42.482A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S42.482A 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).