ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesS42.212

S42.212

Billable

Unspecified displaced fracture of surgical neck of left humerus

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

Code Description

ICD-10 S42.212 is a billable code used to indicate a diagnosis of unspecified displaced fracture of surgical neck of left humerus.

Key Diagnostic Point:

The unspecified displaced fracture of the surgical neck of the left humerus is a common injury, particularly among older adults and individuals involved in high-impact sports. This type of fracture typically occurs due to falls or direct trauma to the shoulder area. The surgical neck is located just below the head of the humerus and is a frequent site for fractures due to its anatomical vulnerability. Patients may present with severe pain, swelling, and limited range of motion in the shoulder. Diagnosis is usually confirmed through physical examination and imaging studies, such as X-rays or CT scans, which help to assess the displacement and alignment of the fracture. Treatment options may vary based on the severity of the fracture and the patient's overall health, ranging from conservative management with immobilization to surgical intervention for realignment and stabilization. Surgical options may include the use of plates, screws, or intramedullary nails. Rehabilitation is crucial for restoring function and strength in the shoulder post-fracture.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture presentation and displacement
  • Need for precise documentation of fracture type and location
  • Potential for surgical intervention requiring additional coding
  • Differentiation from other shoulder injuries such as dislocations

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to capture surgical interventions
  • Misclassification of fracture type
  • Lack of follow-up documentation for rehabilitation

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 falls, sports injuries, or trauma requiring surgical repair.

Billing Considerations

Ensure documentation specifies the type of fracture and any surgical procedures performed.

Physical Therapy

Documentation Requirements

Progress notes detailing rehabilitation protocols and patient responses to treatment.

Common Clinical Scenarios

Patients recovering from surgical repair of humeral fractures.

Billing Considerations

Document functional limitations and progress towards rehabilitation goals.

Coding Guidelines

Inclusion Criteria

Use S42.212 When
  • Follow official ICD
  • CM guidelines for coding fractures, including specificity in documentation regarding the type and location of the fracture
  • Ensure compliance with guidelines for coding surgical procedures if applicable

Exclusion Criteria

Do NOT use S42.212 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23630CPT Code

Open treatment of humeral head fracture

Clinical Scenario

Used when surgical intervention is performed for a displaced fracture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must ensure accurate coding of the procedure performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding fractures, including the ability to denote laterality and displacement, which is crucial for appropriate treatment and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding fractures, including the ability to denote laterality and displacement, which is crucial for appropriate treatment and reimbursement.

Reimbursement & Billing Impact

reimbursement.

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, while a non-displaced fracture means the bone remains in its normal position despite the fracture.