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ICD-10 Guide
ICD-10 CodesS42.021

S42.021

Billable

Displaced fracture of shaft of right clavicle

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/24/2025

Code Description

ICD-10 S42.021 is a billable code used to indicate a diagnosis of displaced fracture of shaft of right clavicle.

Key Diagnostic Point:

A displaced fracture of the shaft of the right clavicle occurs when the bone is broken and the fragments are misaligned, which can lead to significant functional impairment and pain. This type of fracture is commonly caused by trauma, such as a fall onto the shoulder or a direct blow to the area. Clinically, patients may present with shoulder pain, swelling, and a visible deformity. The fracture may also affect surrounding structures, including nerves and blood vessels, necessitating careful evaluation. Diagnosis is typically confirmed through physical examination and imaging studies, such as X-rays. Treatment options vary based on the severity of the fracture and may include conservative management with immobilization or surgical intervention to realign and stabilize the bone. Surgical options may involve the use of plates, screws, or intramedullary rods. Rehabilitation is crucial for restoring function and strength to the shoulder joint post-injury.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between displaced and non-displaced fractures
  • Understanding the anatomical location of the fracture
  • Identifying associated injuries (e.g., nerve damage)
  • Variability in treatment approaches (surgical vs. conservative)

Audit Risk Factors

  • Inadequate documentation of fracture type and displacement
  • Failure to document associated injuries
  • Incorrect coding of surgical procedures performed
  • Misalignment with clinical findings in the medical record

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging results, and follow-up notes are essential for accurate coding.

Common Clinical Scenarios

Fractures resulting from sports injuries, falls, or accidents requiring surgical intervention.

Billing Considerations

Ensure that all surgical procedures and post-operative care are documented to support coding.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional status and rehabilitation progress are necessary.

Common Clinical Scenarios

Patients undergoing rehabilitation after surgical repair of clavicle fractures.

Billing Considerations

Documenting the patient's recovery trajectory and any complications is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use S42.021 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture type, location, and any associated injuries
  • Include details from imaging studies and clinical evaluations

Exclusion Criteria

Do NOT use S42.021 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Repair of fractured clavicle

Clinical Scenario

Used when surgical intervention is performed to repair the fracture.

Documentation Requirements

Operative report detailing the procedure and any complications.

Specialty Considerations

Orthopedic surgeons must document the specifics of the fracture and repair technique.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fractures, including details about displacement and laterality, which enhances the accuracy of patient records and billing.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, including details about displacement and laterality, which enhances the accuracy of patient records and billing.

Reimbursement & Billing Impact

billing.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between a displaced and non-displaced fracture?

A displaced fracture means the bone fragments are misaligned, while a non-displaced fracture means the bone remains in its normal position despite being broken.