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 CodesS42.279

S42.279

Billable

Torus fracture of upper end of unspecified humerus

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

Code Description

ICD-10 S42.279 is a billable code used to indicate a diagnosis of torus fracture of upper end of unspecified humerus.

Key Diagnostic Point:

A torus fracture, also known as a buckle fracture, is a common type of incomplete fracture typically seen in children, characterized by a bulging or buckling of the cortex of the bone without a complete break. In the case of the upper end of the humerus, this type of fracture often occurs due to a fall or direct impact, leading to localized pain, swelling, and limited range of motion in the shoulder. The upper end of the humerus includes the humeral head and greater tuberosity, which are critical for shoulder function and stability. Diagnosis is usually confirmed through X-ray imaging, which reveals the characteristic appearance of the torus fracture. Treatment typically involves immobilization with a splint or cast, and in some cases, physical therapy may be required to restore function. While torus fractures generally have a good prognosis, they can sometimes be misdiagnosed as more severe injuries, necessitating careful evaluation and follow-up. Understanding the nuances of this fracture type is essential for accurate coding and appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between torus fractures and complete fractures.
  • Understanding the anatomical specifics of the humerus.
  • Recognizing the age-related prevalence of torus fractures.
  • Identifying associated soft tissue injuries.

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury.
  • Failure to specify the laterality of the fracture.
  • Misclassification of fracture type (torus vs. complete).
  • Lack of follow-up documentation on treatment outcomes.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the mechanism of injury, imaging results, and treatment plan.

Common Clinical Scenarios

Fractures resulting from falls, sports injuries, or accidents in pediatric patients.

Billing Considerations

Ensure accurate documentation of fracture type and location to avoid miscoding.

Pediatrics

Documentation Requirements

Thorough history and physical examination notes, including developmental milestones.

Common Clinical Scenarios

Children presenting with arm pain after a fall, often requiring imaging to confirm diagnosis.

Billing Considerations

Consider age-related factors in fracture healing and treatment approaches.

Coding Guidelines

Inclusion Criteria

Use S42.279 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code reflects the specific type of fracture and its location
  • Include any relevant external cause codes if applicable

Exclusion Criteria

Do NOT use S42.279 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopy, shoulder, diagnostic

Clinical Scenario

Used when assessing for associated injuries in a patient with a humeral fracture.

Documentation Requirements

Document indications for arthroscopy and findings.

Specialty Considerations

Orthopedic surgeons should ensure clear documentation of the 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, including torus fractures, which enhances the accuracy of patient records and facilitates better treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, including torus fractures, which enhances the accuracy of patient records and facilitates better treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, including torus fractures, which enhances the accuracy of patient records and facilitates better 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 a torus fracture?

A torus fracture is an incomplete fracture commonly seen in children, characterized by a bulging of the bone cortex without a complete break.