S42.209 — Unspecified fracture of upper end of unspecified humerus
Is S42.209 billable?
No — S42.209 is a non-billable header code. S42.209 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 S42.209.
Billable codes under this header
- S42.209AUnspecified fracture of upper end of unspecified humerus, initial encounter for closed fracture
- S42.209BUnspecified fracture of upper end of unspecified humerus, initial encounter for open fracture
- S42.209DUnspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with routine healing
- S42.209GUnspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with delayed healing
- S42.209KUnspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with nonunion
- S42.209PUnspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with malunion
- S42.209SUnspecified fracture of upper end of unspecified humerus, sequela
S42.209 at a glance
| Code | S42.209 |
|---|---|
| Description | Unspecified fracture of upper end of unspecified humerus |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
How is S42.209 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S42.20, the nearest indexed parent of S42.209. Use them to find the family, then select the specific code.
- Fracture, traumatic › humerus › upper end (abduction) (adduction) (separation)
Excludes1 — never code together — inherited from S42
The conditions below can never be reported together with S42.209 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 S42.209 to fully describe the condition. S42.209 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 S42.209, but a patient may have both at the same time. When documentation supports it, S42.209 and the excluded code may both be reported.
Excludes2 — not included here — inherited from S40-S49
The conditions below are not part of S42.209, but a patient may have both at the same time. When documentation supports it, S42.209 and the excluded code may both be reported.
Excludes2 — not included here — inherited from S42
The conditions below are not part of S42.209, but a patient may have both at the same time. When documentation supports it, S42.209 and the excluded code may both be reported.
- periprosthetic fracture around internal prosthetic shoulder joint (M97.3)
Excludes2 — not included here — inherited from S42.2
The conditions below are not part of S42.209, but a patient may have both at the same time. When documentation supports it, S42.209 and the excluded code may both be reported.
What codes fall under S42.209? (7)
- S42.209AUnspecified fracture of upper end of unspecified humerus, initial encounter for closed fracture
- S42.209BUnspecified fracture of upper end of unspecified humerus, initial encounter for open fracture
- S42.209DUnspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with routine healing
- S42.209GUnspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with delayed healing
- S42.209KUnspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with nonunion
- S42.209PUnspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with malunion
- S42.209SUnspecified fracture of upper end of unspecified humerus, sequela
How long has S42.209 existed?
S42.209 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.