S42.494
S42.494 — Other nondisplaced fracture of lower end of right humerus
Non-billable headerICD-10-CMright
S42.494 is a non-billable header ICD-10-CM code for other nondisplaced fracture of lower end of right 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
S42.494 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 S42.494
7 child codes. Green means billable.
- S42.494AOther nondisplaced fracture of lower end of right humerus, initial encounter for closed fracture
- S42.494BOther nondisplaced fracture of lower end of right humerus, initial encounter for open fracture
- S42.494DOther nondisplaced fracture of lower end of right humerus, subsequent encounter for fracture with routine healing
- S42.494GOther nondisplaced fracture of lower end of right humerus, subsequent encounter for fracture with delayed healing
- S42.494KOther nondisplaced fracture of lower end of right humerus, subsequent encounter for fracture with nonunion
- S42.494POther nondisplaced fracture of lower end of right humerus, subsequent encounter for fracture with malunion
- S42.494SOther nondisplaced fracture of lower end of right humerus, sequela
Related codes at this level
Codes that share S42.49. If S42.494 is not quite right, the correct code is usually one of these.
- S42.491Other displaced fracture of lower end of right humerus
- S42.492Other displaced fracture of lower end of left humerus
- S42.493Other displaced fracture of lower end of unspecified humerus
- S42.495Other nondisplaced fracture of lower end of left humerus
- S42.496Other nondisplaced fracture of lower end of unspecified humerus
Questions about S42.494
- Is S42.494 a billable ICD-10-CM code?
- No. S42.494 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S42.494 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).