S42.109 — Fracture of unspecified part of scapula, unspecified shoulder
Is S42.109 billable?
No — S42.109 is a non-billable header code. S42.109 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 7 billable codes beneath S42.109.
Billable codes under this header
- 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
S42.109 at a glance
| Code | S42.109 |
|---|---|
| Description | Fracture of unspecified part of scapula, unspecified shoulder |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
How is S42.109 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S42.10, the nearest indexed parent of S42.109. 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 S42.109 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 S42.109 to fully describe the condition. S42.109 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 S42.109, but a patient may have both at the same time. When documentation supports it, S42.109 and the excluded code may both be reported.
Excludes2 — not included here — inherited from S40-S49
The conditions below are not part of S42.109, but a patient may have both at the same time. When documentation supports it, S42.109 and the excluded code may both be reported.
Excludes2 — not included here — inherited from S42
The conditions below are not part of S42.109, but a patient may have both at the same time. When documentation supports it, S42.109 and the excluded code may both be reported.
- periprosthetic fracture around internal prosthetic shoulder joint (M97.3)
What codes fall under S42.109? (7)
- 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
How long has S42.109 existed?
S42.109 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.