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 CodesS42.292

S42.292

Billable

Other displaced fracture of upper end of left humerus

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

Code Description

ICD-10 S42.292 is a billable code used to indicate a diagnosis of other displaced fracture of upper end of left humerus.

Key Diagnostic Point:

The S42.292 code refers to a specific type of fracture occurring at the upper end of the left humerus, which is the long bone of the upper arm. This fracture is classified as 'displaced,' meaning that the bone fragments have moved out of their normal alignment. Such fractures can occur due to trauma, such as falls or direct blows, and are often associated with significant pain, swelling, and limited range of motion in the shoulder. The upper end of the humerus includes the anatomical neck, surgical neck, and greater and lesser tuberosities, which are critical for shoulder function and stability. Displaced fractures in this area can lead to complications such as rotator cuff injuries, shoulder dislocations, and may require surgical intervention for proper alignment and healing. Treatment options may include immobilization with a sling, physical therapy, or surgical repair, depending on the severity and specific characteristics of the fracture. Accurate coding is essential for appropriate treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and locations
  • Need for precise documentation of displacement
  • Potential for associated injuries (e.g., rotator cuff tears)
  • Differentiation from non-displaced fractures

Audit Risk Factors

  • Inadequate documentation of fracture type and displacement
  • Failure to document associated injuries
  • Incorrect coding of laterality (left vs. right)
  • Misinterpretation of imaging results

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 accidents requiring surgical intervention.

Billing Considerations

Documentation must clearly indicate the type of fracture, treatment provided, and any complications.

Physical Therapy

Documentation Requirements

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

Common Clinical Scenarios

Post-operative rehabilitation following surgical repair of humeral fractures.

Billing Considerations

Therapy notes should correlate with the surgical procedure and demonstrate the need for ongoing treatment.

Coding Guidelines

Inclusion Criteria

Use S42.292 When
  • According to ICD
  • 10 guidelines, S42
  • 292 should be used when a displaced fracture of the upper end of the left humerus is confirmed through imaging
  • It is important to document the mechanism of injury and any associated conditions

Exclusion Criteria

Do NOT use S42.292 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopic rotator cuff repair

Clinical Scenario

Used when a rotator cuff injury is present alongside the humeral fracture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the relationship between the fracture and any rotator cuff repair performed.

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 diagnoses and treatment plans. S42.292 provides a clear distinction for displaced fractures, which is critical for appropriate management and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of diagnoses and treatment plans. S42.292 provides a clear distinction for displaced fractures, which is critical for appropriate management 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 S42.292 and S42.291?

S42.292 refers to a displaced fracture of the upper end of the left humerus, while S42.291 refers to a non-displaced fracture. The distinction is important for treatment and coding purposes.