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 CodesS42.223

S42.223

Billable

2-part displaced fracture of surgical neck of unspecified humerus

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

Code Description

ICD-10 S42.223 is a billable code used to indicate a diagnosis of 2-part displaced fracture of surgical neck of unspecified humerus.

Key Diagnostic Point:

A 2-part displaced fracture of the surgical neck of the humerus typically occurs due to trauma, such as a fall or direct impact to the shoulder. This type of fracture is characterized by a break in the bone that results in two separate fragments, which are misaligned or displaced from their normal anatomical position. The surgical neck is located just below the head of the humerus and is a common site for fractures, particularly in older adults or individuals with osteoporosis. Symptoms often include severe shoulder pain, swelling, bruising, and limited range of motion. Diagnosis is usually confirmed through imaging studies such as X-rays or CT scans. Treatment may involve conservative management with immobilization or surgical intervention, depending on the degree of displacement and the patient's overall health. Surgical options may include open reduction and internal fixation (ORIF) or shoulder arthroplasty in more severe cases. Rehabilitation is crucial for restoring function and strength post-injury.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture classification and terminology
  • Need for precise documentation of displacement and fracture type
  • Potential for multiple treatment options impacting coding
  • Differentiation from similar codes related to humeral fractures

Audit Risk Factors

  • Inadequate documentation of fracture type and displacement
  • Failure to specify laterality or anatomical details
  • Misclassification of fracture severity
  • Inconsistent coding of associated shoulder injuries

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

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

Billing Considerations

Ensure clear documentation of fracture type, displacement, and any surgical procedures performed.

Physical Therapy

Documentation Requirements

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

Common Clinical Scenarios

Post-operative rehabilitation following surgical repair of humeral fractures.

Billing Considerations

Document functional limitations and progress towards rehabilitation milestones.

Coding Guidelines

Inclusion Criteria

Use S42.223 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of fracture type, laterality, and any associated injuries
  • Include details on treatment plans and outcomes

Exclusion Criteria

Do NOT use S42.223 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23630CPT Code

Open treatment of humeral fracture, surgical neck

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 document the specifics of the fracture and 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 claims and facilitating better patient care through detailed documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of claims and facilitating better patient care through detailed documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of claims and facilitating better patient care through detailed documentation.

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 S42.223 and S42.221?

S42.223 refers to a 2-part displaced fracture, while S42.221 is for a non-displaced fracture. Accurate documentation of displacement is crucial for correct coding.