S42.496
S42.496 — Other nondisplaced fracture of lower end of unspecified humerus
Non-billable headerICD-10-CM
S42.496 is a non-billable header ICD-10-CM code for other nondisplaced fracture of lower end 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
S42.496 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 S42.496
7 child codes. Green means billable.
- S42.496AOther nondisplaced fracture of lower end of unspecified humerus, initial encounter for closed fracture
- S42.496BOther nondisplaced fracture of lower end of unspecified humerus, initial encounter for open fracture
- S42.496DOther nondisplaced fracture of lower end of unspecified humerus, subsequent encounter for fracture with routine healing
- S42.496GOther nondisplaced fracture of lower end of unspecified humerus, subsequent encounter for fracture with delayed healing
- S42.496KOther nondisplaced fracture of lower end of unspecified humerus, subsequent encounter for fracture with nonunion
- S42.496POther nondisplaced fracture of lower end of unspecified humerus, subsequent encounter for fracture with malunion
- S42.496SOther nondisplaced fracture of lower end of unspecified humerus, sequela
Related codes at this level
Codes that share S42.49. If S42.496 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
- S42.494Other nondisplaced fracture of lower end of right humerus
- S42.495Other nondisplaced fracture of lower end of left humerus
Questions about S42.496
- Is S42.496 a billable ICD-10-CM code?
- No. S42.496 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S42.496 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).