S42.92XG
S42.92XG: Fracture of left shoulder girdle, part unspecified, subsequent encounter for fracture with delayed healing
Billable / specific codeICD-10-CMPOA exemptleft
S42.92XG is a billable, specific ICD-10-CM code for fracture of left shoulder girdle, part unspecified, subsequent encounter for fracture with delayed healing. It is valid for submission on a claim.
Check S42.92XG with the rest of the claim: free scrubber7th character "G": subsequent encounter for fracture with delayed healing
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
Excludes1 inherited from the categories above S42.92XG
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S42.92XG
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with S42.92XG
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
S42.92XG is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53065Billing and Coding: Outpatient Physical Therapy
- A57311Billing and Coding: Physical Therapy - Home Health
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S42.92
- S42.92XAFracture of left shoulder girdle, part unspecified, initial encounter for closed fracture
- S42.92XBFracture of left shoulder girdle, part unspecified, initial encounter for open fracture
- S42.92XDFracture of left shoulder girdle, part unspecified, subsequent encounter for fracture with routine healing
- S42.92XKFracture of left shoulder girdle, part unspecified, subsequent encounter for fracture with nonunion
- S42.92XPFracture of left shoulder girdle, part unspecified, subsequent encounter for fracture with malunion
- S42.92XSFracture of left shoulder girdle, part unspecified, sequela