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v1.0.0
ICD-10 Guide
ICD-10 CodesS42.023

S42.023

Billable

Displaced fracture of shaft of unspecified clavicle

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

Code Description

ICD-10 S42.023 is a billable code used to indicate a diagnosis of displaced fracture of shaft of unspecified clavicle.

Key Diagnostic Point:

A displaced fracture of the shaft of the clavicle occurs when the bone is broken and the fragments are misaligned. This type of fracture is often the result of trauma, such as a fall or direct impact to the shoulder area. The clavicle, or collarbone, connects the arm to the body and plays a crucial role in shoulder function. Symptoms typically include pain, swelling, and difficulty moving the arm. Diagnosis is usually confirmed through physical examination and imaging studies, such as X-rays. Treatment may involve conservative management with immobilization or surgical intervention, depending on the severity and displacement of the fracture. Surgical options may include open reduction and internal fixation (ORIF) to realign the bone fragments. Rehabilitation is essential for restoring function and strength to the shoulder after healing. Understanding the nuances of this fracture is critical for accurate coding and appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and locations
  • Need for precise documentation of displacement
  • Differentiation from non-displaced fractures
  • Potential for associated injuries (e.g., nerve or vascular damage)

Audit Risk Factors

  • Inadequate documentation of fracture type and displacement
  • Failure to document associated injuries
  • Incorrect coding of fracture location
  • Lack of clarity on treatment plan (surgical vs. conservative)

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Fractures resulting from sports injuries, falls, or vehicular accidents.

Billing Considerations

Documentation must clearly indicate the type of fracture, treatment provided, and any complications.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional status and rehabilitation progress.

Common Clinical Scenarios

Patients undergoing rehabilitation post-fracture repair.

Billing Considerations

Focus on functional outcomes and the impact of the fracture on daily activities.

Coding Guidelines

Inclusion Criteria

Use S42.023 When
  • Follow the official ICD
  • CM guidelines for coding fractures, ensuring accurate documentation of the fracture type, location, and treatment
  • Include any associated injuries or complications

Exclusion Criteria

Do NOT use S42.023 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23615CPT Code

Open treatment of clavicular fracture

Clinical Scenario

Used when surgical intervention is performed for a displaced clavicle fracture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the specifics of the fracture and the surgical approach.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of data collection and reimbursement processes. S42.023 provides a clear distinction for displaced fractures, which is critical for treatment planning and outcomes tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of data collection and reimbursement processes. S42.023 provides a clear distinction for displaced fractures, which is critical for treatment planning and outcomes tracking.

Reimbursement & Billing Impact

reimbursement processes. S42.023 provides a clear distinction for displaced fractures, which is critical for treatment planning and outcomes tracking.

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 clavicle 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.