S42.116 — Nondisplaced fracture of body of scapula, unspecified shoulder
Is S42.116 billable?
No — S42.116 is a non-billable header code. S42.116 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 S42.116.
Billable codes under this header
- 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
- S42.116KNondisplaced fracture of body of scapula, unspecified shoulder, subsequent encounter for fracture with nonunion
- S42.116PNondisplaced fracture of body of scapula, unspecified shoulder, subsequent encounter for fracture with malunion
- S42.116SNondisplaced fracture of body of scapula, unspecified shoulder, sequela
S42.116 at a glance
| Code | S42.116 |
|---|---|
| Description | Nondisplaced fracture of body 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 S42.116 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S42.11, the nearest indexed parent of S42.116. Use them to find the family, then select the specific code.
- Fracture, traumatic › scapula › body (abduction) (adduction) (separation)
- Fracture, traumatic › scapula › body › nondisplaced (abduction) (adduction) (separation)
Excludes1 — never code together — inherited from S42
The conditions below can never be reported together with S42.116 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 S42.116 to fully describe the condition. S42.116 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 S42.116, but a patient may have both at the same time. When documentation supports it, S42.116 and the excluded code may both be reported.
Excludes2 — not included here — inherited from S40-S49
The conditions below are not part of S42.116, but a patient may have both at the same time. When documentation supports it, S42.116 and the excluded code may both be reported.
Excludes2 — not included here — inherited from S42
The conditions below are not part of S42.116, but a patient may have both at the same time. When documentation supports it, S42.116 and the excluded code may both be reported.
- periprosthetic fracture around internal prosthetic shoulder joint (M97.3)
What codes fall under S42.116? (7)
- 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
- S42.116KNondisplaced fracture of body of scapula, unspecified shoulder, subsequent encounter for fracture with nonunion
- S42.116PNondisplaced fracture of body of scapula, unspecified shoulder, subsequent encounter for fracture with malunion
- S42.116SNondisplaced fracture of body of scapula, unspecified shoulder, sequela
How long has S42.116 existed?
S42.116 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.
What other codes are in the S42.11 family? (5)
- S42.111Displaced fracture of body of scapula, right shouldernot billable
- S42.112Displaced fracture of body of scapula, left shouldernot billable
- S42.113Displaced fracture of body of scapula, unspecified shouldernot billable
- S42.114Nondisplaced fracture of body of scapula, right shouldernot billable
- S42.115Nondisplaced fracture of body of scapula, left shouldernot billable