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ICD-10 Guide
ICD-10 CodesS42.035

S42.035

Billable

Nondisplaced fracture of lateral end of left clavicle

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

Code Description

ICD-10 S42.035 is a billable code used to indicate a diagnosis of nondisplaced fracture of lateral end of left clavicle.

Key Diagnostic Point:

A nondisplaced fracture of the lateral end of the left clavicle occurs when there is a break in the bone without any significant displacement of the fracture fragments. This type of fracture is often caused by direct trauma, such as a fall onto the shoulder or an impact during sports activities. Clinically, patients may present with localized pain, swelling, and tenderness over the lateral aspect of the clavicle. Range of motion may be limited, particularly in shoulder abduction and adduction. Diagnosis is typically confirmed through physical examination and imaging studies, such as X-rays, which reveal the fracture without displacement. Treatment usually involves conservative management, including rest, ice application, and immobilization with a sling. In some cases, physical therapy may be recommended to restore strength and mobility. Surgical intervention is rarely required for nondisplaced fractures unless there are associated injuries or complications. Understanding the nuances of this condition is essential for accurate coding and appropriate management.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Clear clinical definition with specific anatomical location
  • Well-established treatment protocols
  • Low likelihood of complications
  • Standard imaging requirements for diagnosis

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify laterality (left vs. right)
  • Misclassification of fracture type (nondisplaced vs. displaced)
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the mechanism of injury, physical examination findings, and treatment plan.

Common Clinical Scenarios

Patients presenting with shoulder pain after a fall or sports injury.

Billing Considerations

Ensure accurate laterality and fracture type are documented to avoid coding errors.

Physical Therapy

Documentation Requirements

Progress notes detailing rehabilitation exercises and patient response.

Common Clinical Scenarios

Patients undergoing rehabilitation post-fracture for strength and mobility.

Billing Considerations

Document specific exercises and patient progress to support billing.

Coding Guidelines

Inclusion Criteria

Use S42.035 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the fracture type and laterality
  • Include any relevant external cause codes if applicable

Exclusion Criteria

Do NOT use S42.035 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29505CPT Code

Application of a shoulder sling

Clinical Scenario

Used for immobilization of the shoulder after a nondisplaced fracture.

Documentation Requirements

Document the type of sling used and duration of immobilization.

Specialty Considerations

Orthopedic specialists should ensure proper coding for the application of slings.

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. S42.035 provides a clear distinction from other fracture types, aiding in clinical decision-making.

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. S42.035 provides a clear distinction from other fracture types, aiding in clinical decision-making.

Reimbursement & Billing Impact

reimbursement processes. S42.035 provides a clear distinction from other fracture types, aiding in clinical decision-making.

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 nondisplaced and displaced fracture?

A nondisplaced fracture means the bone cracks but maintains its proper alignment, while a displaced fracture involves the bone fragments moving out of alignment.