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 CodesS42.262

S42.262

Billable

Displaced fracture of lesser tuberosity of left humerus

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

Code Description

ICD-10 S42.262 is a billable code used to indicate a diagnosis of displaced fracture of lesser tuberosity of left humerus.

Key Diagnostic Point:

A displaced fracture of the lesser tuberosity of the left humerus typically occurs due to trauma, such as a fall or direct impact to the shoulder. The lesser tuberosity is a small bony prominence located on the anterior aspect of the humerus, serving as an attachment point for the subscapularis muscle, which is a key component of the rotator cuff. This type of fracture can lead to significant pain, limited range of motion, and potential complications such as rotator cuff tears or shoulder instability. Diagnosis is usually confirmed through imaging studies, including X-rays or MRI, which can reveal the extent of displacement and any associated injuries. Treatment often involves surgical intervention, particularly if the fracture is significantly displaced, to restore normal anatomy and function. Surgical options may include open reduction and internal fixation (ORIF) or arthroscopic techniques, depending on the fracture's complexity and the patient's overall health. Post-operative rehabilitation is crucial for restoring shoulder function and strength, and may involve physical therapy to address any residual limitations.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of specific anatomical terminology related to the humerus.
  • Involves knowledge of surgical procedures for fracture repair.
  • Differentiating between displaced and non-displaced fractures.
  • Potential for associated rotator cuff injuries complicating the diagnosis.

Audit Risk Factors

  • Inadequate documentation of the fracture type and displacement.
  • Failure to document associated injuries, such as rotator cuff tears.
  • Incorrect coding of the side (left vs. right).
  • Lack of clarity in surgical reports regarding the procedure performed.

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Fractures resulting from falls, sports injuries, or motor vehicle accidents.

Billing Considerations

Ensure clear documentation of fracture displacement and any surgical interventions performed.

Physical Therapy

Documentation Requirements

Progress notes detailing rehabilitation protocols and patient responses.

Common Clinical Scenarios

Post-operative rehabilitation following shoulder surgery for fractures.

Billing Considerations

Document functional limitations and progress towards recovery.

Coding Guidelines

Inclusion Criteria

Use S42.262 When
  • Follow the ICD
  • CM guidelines for coding fractures, including specificity for the type of fracture and laterality
  • Ensure compliance with documentation standards for surgical procedures

Exclusion Criteria

Do NOT use S42.262 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopy, shoulder, surgical; with rotator cuff repair

Clinical Scenario

Used when a rotator cuff repair is performed alongside fracture fixation.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons should ensure accurate linkage between the fracture and repair.

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 accurate billing and treatment planning.

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 accurate billing and treatment planning.

Reimbursement & Billing Impact

billing and treatment planning.

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 significance of coding the fracture as displaced?

Coding the fracture as displaced is crucial as it impacts treatment decisions, surgical interventions, and rehabilitation protocols. Displaced fractures often require more complex management compared to non-displaced fractures.