S42.101P — Fracture of unspecified part of scapula, right shoulder, subsequent encounter for fracture with malunion
Is S42.101P billable?
Yes, but S42.101P is an unspecified code. S42.101P is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, S42.101P is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting S42.101P — the more specific alternatives are listed below.
More specific alternatives
- S42.111PDisplaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with malunion
- S42.121PDisplaced fracture of acromial process, right shoulder, subsequent encounter for fracture with malunion
- S42.131PDisplaced fracture of coracoid process, right shoulder, subsequent encounter for fracture with malunion
- S42.141PDisplaced fracture of glenoid cavity of scapula, right shoulder, subsequent encounter for fracture with malunion
- S42.151PDisplaced fracture of neck of scapula, right shoulder, subsequent encounter for fracture with malunion
- S42.191PFracture of other part of scapula, right shoulder, subsequent encounter for fracture with malunion
S42.101P at a glance
| Code | S42.101P |
|---|---|
| Description | Fracture of unspecified part of scapula, right shoulder, subsequent encounter for fracture with malunion |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "P" | subsequent encounter for fracture with malunion |
What does the 7th character "P" mean in S42.101P?
In S42.101P, the 7th character P means subsequent encounter for fracture with malunion. The 7th character is required for S42.101P to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
- Ainitial encounter for closed fractureS42.101A
- Binitial encounter for open fractureS42.101B
- Dsubsequent encounter for fracture with routine healingS42.101D
- Gsubsequent encounter for fracture with delayed healingS42.101G
- Ksubsequent encounter for fracture with nonunionS42.101K
- Psubsequent encounter for fracture with malunionS42.101P
- SsequelaS42.101S
Which MS-DRGs does S42.101P group to?
S42.101P sits in MDC 08 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 564Other Musculoskeletal System and Connective Tissue Diagnoses with MCCmedical
- 565Other Musculoskeletal System and Connective Tissue Diagnoses with CCmedical
- 566Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCCmedical
As a secondary diagnosis, S42.101P is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is S42.101P listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S42.10, the nearest indexed parent of S42.101P. Use them to find the family, then select the specific code.
- Fracture, traumatic › scapula (abduction) (adduction) (separation)
Excludes1 — never code together — inherited from S42
The conditions below can never be reported together with S42.101P 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 S42.101P to fully describe the condition. S42.101P 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 S42.101P, but a patient may have both at the same time. When documentation supports it, S42.101P and the excluded code may both be reported.
Excludes2 — not included here — inherited from S40-S49
The conditions below are not part of S42.101P, but a patient may have both at the same time. When documentation supports it, S42.101P and the excluded code may both be reported.
Excludes2 — not included here — inherited from S42
The conditions below are not part of S42.101P, but a patient may have both at the same time. When documentation supports it, S42.101P and the excluded code may both be reported.
- periprosthetic fracture around internal prosthetic shoulder joint (M97.3)
How long has S42.101P existed?
S42.101P 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.