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ICD-10 Guide
ICD-10 CodesS42.151

S42.151

Billable

Displaced fracture of neck of scapula, right shoulder

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

Code Description

ICD-10 S42.151 is a billable code used to indicate a diagnosis of displaced fracture of neck of scapula, right shoulder.

Key Diagnostic Point:

A displaced fracture of the neck of the scapula is a significant injury that typically results from high-energy trauma, such as a fall from a height or a motor vehicle accident. This type of fracture can lead to considerable pain, limited range of motion, and functional impairment of the shoulder. The neck of the scapula is the area just below the glenoid cavity, where the humerus articulates with the scapula. Displacement refers to the misalignment of the fracture fragments, which can complicate healing and may require surgical intervention. Patients often present with shoulder pain, swelling, and difficulty in moving the arm. Diagnosis is confirmed through imaging studies, such as X-rays or CT scans, which reveal the fracture's location and displacement. Treatment options vary based on the severity of the fracture and may include conservative management with immobilization or surgical repair to restore anatomical alignment and function. Rehabilitation is crucial for recovery, focusing on restoring range of motion and strength to prevent long-term disability.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires precise documentation of fracture type and location.
  • Differentiation from similar shoulder injuries (e.g., humeral fractures).
  • Potential for surgical intervention complicates coding.
  • Need for accurate imaging reports to support coding.

Audit Risk Factors

  • Inadequate documentation of fracture displacement.
  • Failure to specify the right shoulder in documentation.
  • Lack of imaging reports to support the diagnosis.
  • Incorrect coding of related procedures or surgeries.

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging studies, and pre-operative assessments.

Common Clinical Scenarios

Surgical repair of displaced scapular fractures, post-operative follow-ups.

Billing Considerations

Ensure documentation reflects the complexity of the fracture and any surgical interventions performed.

Physical Therapy

Documentation Requirements

Progress notes detailing range of motion, strength assessments, and rehabilitation goals.

Common Clinical Scenarios

Rehabilitation post-surgery for scapular fractures, management of pain and mobility.

Billing Considerations

Document functional limitations and progress towards rehabilitation goals.

Coding Guidelines

Inclusion Criteria

Use S42.151 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 surgical reports when applicable

Exclusion Criteria

Do NOT use S42.151 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopy, shoulder, surgical

Clinical Scenario

Used for surgical repair of displaced scapular fractures.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of shoulder injuries, including displaced fractures of the scapula. This specificity aids in better tracking of injury patterns and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of shoulder injuries, including displaced fractures of the scapula. This specificity aids in better tracking of injury patterns and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of shoulder injuries, including displaced fractures of the scapula. This specificity aids in better tracking of injury patterns and treatment outcomes.

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 that the bone fragments are not aligned properly, while a non-displaced fracture means the bone remains in its normal position despite the fracture.