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ICD-10 Guide
ICD-10 CodesS42.152

S42.152

Billable

Displaced fracture of neck of scapula, left shoulder

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

Code Description

ICD-10 S42.152 is a billable code used to indicate a diagnosis of displaced fracture of neck of scapula, left shoulder.

Key Diagnostic Point:

A displaced fracture of the neck of the scapula is a serious injury that typically occurs due to high-impact trauma, such as falls or vehicular accidents. The scapula, or shoulder blade, plays a crucial role in shoulder stability and mobility. A fracture in this area can lead to significant pain, limited range of motion, and potential complications such as rotator cuff injuries or shoulder dislocations. Patients may present with swelling, bruising, and tenderness around the shoulder region. Diagnosis is usually confirmed through imaging studies, such as X-rays or CT scans, which help determine the extent of the fracture and any associated injuries. Treatment often involves immobilization, pain management, and in some cases, surgical intervention to realign the fractured bone and restore function. Rehabilitation is essential for recovery, focusing on restoring strength and mobility to the shoulder joint.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between displaced and non-displaced fractures
  • Identifying associated injuries such as rotator cuff tears
  • Understanding the anatomical terminology related to the scapula
  • Documenting the mechanism of injury accurately

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of fracture (displaced vs. non-displaced)
  • Lack of imaging reports to support the diagnosis
  • Incorrect coding of associated injuries or conditions

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and pre-operative assessments are essential.

Common Clinical Scenarios

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

Billing Considerations

Ensure accurate coding of any surgical repairs or interventions performed.

Physical Therapy

Documentation Requirements

Progress notes detailing the patient's rehabilitation progress and response to therapy.

Common Clinical Scenarios

Patients recovering from surgical repair of scapular fractures or conservative management.

Billing Considerations

Document functional limitations and goals for therapy to support billing.

Coding Guidelines

Inclusion Criteria

Use S42.152 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the fracture is documented as displaced and specifying the location
  • Include any associated injuries or conditions in the coding

Exclusion Criteria

Do NOT use S42.152 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopic repair of rotator cuff

Clinical Scenario

Used when a rotator cuff injury is identified during the treatment of the scapular fracture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the necessity of the procedure in relation to the fracture.

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 the distinction between displaced and non-displaced fractures, 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 the distinction between displaced and non-displaced fractures, 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 that the bone fragments are not aligned properly, while a non-displaced fracture indicates that the bone remains in its normal position despite the fracture.