ICDcodes.org
FY2027

S42 — Fracture of shoulder and upper arm

Not billable

Is S42 billable?

No — S42 is a non-billable header code. S42 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 60 billable codes beneath S42.

Billable codes under this header

S42 at a glance

CodeS42
DescriptionFracture of shoulder and upper arm
BillableNo — header code
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

Excludes1 — never code together

The conditions below can never be reported together with S42 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • traumatic amputation of shoulder and upper arm (S48.-)

Excludes2 — not included here

The conditions below are not part of S42, but a patient may have both at the same time. When documentation supports it, S42 and the excluded code may both be reported.

  • periprosthetic fracture around internal prosthetic shoulder joint (M97.3)

Note

  • A fracture not indicated as displaced or nondisplaced should be coded to displaced
  • A fracture not indicated as open or closed should be coded to closed

Use additional code — inherited from Chapter 19

Report an additional code alongside S42 to fully describe the condition. S42 is sequenced first.

  • code to identify any retained foreign body, if applicable (Z18.-)

Excludes2 — not included here — inherited from Chapter 19

The conditions below are not part of S42, but a patient may have both at the same time. When documentation supports it, S42 and the excluded code may both be reported.

  • birth trauma (P10-P15)
  • obstetric trauma (O70-O71)

Excludes2 — not included here — inherited from S40-S49

The conditions below are not part of S42, but a patient may have both at the same time. When documentation supports it, S42 and the excluded code may both be reported.

  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • injuries of elbow (S50-S59)
  • insect bite or sting, venomous (T63.4)

What codes fall under S42? (6)

How long has S42 existed?

S42 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.