S42.1 — Fracture of scapula
Not billable
Is S42.1 billable?
No — S42.1 is a non-billable header code. S42.1 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 S42.1.
Billable codes under this header
- S42.101AFracture of unspecified part of scapula, right shoulder, initial encounter for closed fracture
- S42.101BFracture of unspecified part of scapula, right shoulder, initial encounter for open fracture
- S42.101DFracture of unspecified part of scapula, right shoulder, subsequent encounter for fracture with routine healing
- S42.101GFracture of unspecified part of scapula, right shoulder, subsequent encounter for fracture with delayed healing
- S42.101KFracture of unspecified part of scapula, right shoulder, subsequent encounter for fracture with nonunion
- S42.101PFracture of unspecified part of scapula, right shoulder, subsequent encounter for fracture with malunion
- S42.101SFracture of unspecified part of scapula, right shoulder, sequela
- S42.102AFracture of unspecified part of scapula, left shoulder, initial encounter for closed fracture
- S42.102BFracture of unspecified part of scapula, left shoulder, initial encounter for open fracture
- S42.102DFracture of unspecified part of scapula, left shoulder, subsequent encounter for fracture with routine healing
- S42.102GFracture of unspecified part of scapula, left shoulder, subsequent encounter for fracture with delayed healing
- S42.102KFracture of unspecified part of scapula, left shoulder, subsequent encounter for fracture with nonunion
- S42.102PFracture of unspecified part of scapula, left shoulder, subsequent encounter for fracture with malunion
- S42.102SFracture of unspecified part of scapula, left shoulder, sequela
- S42.109AFracture of unspecified part of scapula, unspecified shoulder, initial encounter for closed fracture
- S42.109BFracture of unspecified part of scapula, unspecified shoulder, initial encounter for open fracture
- S42.109DFracture of unspecified part of scapula, unspecified shoulder, subsequent encounter for fracture with routine healing
- S42.109GFracture of unspecified part of scapula, unspecified shoulder, subsequent encounter for fracture with delayed healing
- S42.109KFracture of unspecified part of scapula, unspecified shoulder, subsequent encounter for fracture with nonunion
- S42.109PFracture of unspecified part of scapula, unspecified shoulder, subsequent encounter for fracture with malunion
- S42.109SFracture of unspecified part of scapula, unspecified shoulder, sequela
- S42.111ADisplaced fracture of body of scapula, right shoulder, initial encounter for closed fracture
- S42.111BDisplaced fracture of body of scapula, right shoulder, initial encounter for open fracture
- S42.111DDisplaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with routine healing
- S42.111GDisplaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with delayed healing
- S42.111KDisplaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with nonunion
- S42.111PDisplaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with malunion
- S42.111SDisplaced fracture of body of scapula, right shoulder, sequela
- S42.112ADisplaced fracture of body of scapula, left shoulder, initial encounter for closed fracture
- S42.112BDisplaced fracture of body of scapula, left shoulder, initial encounter for open fracture
- S42.112DDisplaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with routine healing
- S42.112GDisplaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with delayed healing
- S42.112KDisplaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with nonunion
- S42.112PDisplaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with malunion
- S42.112SDisplaced fracture of body of scapula, left shoulder, sequela
- S42.113ADisplaced fracture of body of scapula, unspecified shoulder, initial encounter for closed fracture
- S42.113BDisplaced fracture of body of scapula, unspecified shoulder, initial encounter for open fracture
- S42.113DDisplaced fracture of body of scapula, unspecified shoulder, subsequent encounter for fracture with routine healing
- S42.113GDisplaced fracture of body of scapula, unspecified shoulder, subsequent encounter for fracture with delayed healing
- S42.113KDisplaced fracture of body of scapula, unspecified shoulder, subsequent encounter for fracture with nonunion
- S42.113PDisplaced fracture of body of scapula, unspecified shoulder, subsequent encounter for fracture with malunion
- S42.113SDisplaced fracture of body of scapula, unspecified shoulder, sequela
- S42.114ANondisplaced fracture of body of scapula, right shoulder, initial encounter for closed fracture
- S42.114BNondisplaced fracture of body of scapula, right shoulder, initial encounter for open fracture
- S42.114DNondisplaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with routine healing
- S42.114GNondisplaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with delayed healing
- S42.114KNondisplaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with nonunion
- S42.114PNondisplaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with malunion
- S42.114SNondisplaced fracture of body of scapula, right shoulder, sequela
- S42.115ANondisplaced fracture of body of scapula, left shoulder, initial encounter for closed fracture
- S42.115BNondisplaced fracture of body of scapula, left shoulder, initial encounter for open fracture
- S42.115DNondisplaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with routine healing
- S42.115GNondisplaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with delayed healing
- S42.115KNondisplaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with nonunion
- S42.115PNondisplaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with malunion
- S42.115SNondisplaced fracture of body of scapula, left shoulder, sequela
- S42.116ANondisplaced fracture of body of scapula, unspecified shoulder, initial encounter for closed fracture
- S42.116BNondisplaced fracture of body of scapula, unspecified shoulder, initial encounter for open fracture
- S42.116DNondisplaced fracture of body of scapula, unspecified shoulder, subsequent encounter for fracture with routine healing
- S42.116GNondisplaced fracture of body of scapula, unspecified shoulder, subsequent encounter for fracture with delayed healing
S42.1 at a glance
| Code | S42.1 |
|---|---|
| Description | Fracture of scapula |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Excludes1 — never code together — inherited from S42
The conditions below can never be reported together with S42.1 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.-)
Use additional code — inherited from Chapter 19
Report an additional code alongside S42.1 to fully describe the condition. S42.1 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 S42.1, but a patient may have both at the same time. When documentation supports it, S42.1 and the excluded code may both be reported.
Excludes2 — not included here — inherited from S40-S49
The conditions below are not part of S42.1, but a patient may have both at the same time. When documentation supports it, S42.1 and the excluded code may both be reported.
Excludes2 — not included here — inherited from S42
The conditions below are not part of S42.1, but a patient may have both at the same time. When documentation supports it, S42.1 and the excluded code may both be reported.
- periprosthetic fracture around internal prosthetic shoulder joint (M97.3)
What codes fall under S42.1? (7)
- S42.10Fracture of unspecified part of scapulanot billable
- S42.11Fracture of body of scapulanot billable
- S42.12Fracture of acromial processnot billable
- S42.13Fracture of coracoid processnot billable
- S42.14Fracture of glenoid cavity of scapulanot billable
- S42.15Fracture of neck of scapulanot billable
- S42.19Fracture of other part of scapulanot billable
How long has S42.1 existed?
S42.1 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.