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ICD-10 Guide
ICD-10 CodesS42.322

S42.322

Billable

Displaced transverse fracture of shaft of humerus, left arm

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

Code Description

ICD-10 S42.322 is a billable code used to indicate a diagnosis of displaced transverse fracture of shaft of humerus, left arm.

Key Diagnostic Point:

A displaced transverse fracture of the shaft of the humerus occurs when there is a break in the bone that runs along the upper arm, specifically in the shaft region, and the fracture fragments are not aligned. This type of fracture is often the result of high-energy trauma, such as a fall or a motor vehicle accident, and can lead to significant pain, swelling, and loss of function in the affected arm. Patients may present with an inability to move the arm, visible deformity, and tenderness upon palpation. Diagnosis is typically confirmed through imaging studies, such as X-rays, which reveal the fracture pattern and displacement. Treatment often involves orthopedic intervention, which may include closed reduction and immobilization or surgical repair, depending on the severity and displacement of the fracture. Complications can include nonunion, malunion, and potential injury to surrounding nerves and blood vessels. Rehabilitation is crucial for restoring function and strength to the arm post-injury.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for precise documentation of fracture type and location
  • Differentiation between displaced and non-displaced fractures
  • Potential for associated injuries (e.g., nerve damage)
  • Variability in treatment approaches (surgical vs. non-surgical)

Audit Risk Factors

  • Inadequate documentation of fracture characteristics
  • Failure to specify laterality (left vs. right)
  • Misclassification of fracture type (displaced vs. non-displaced)
  • Lack of imaging reports to support diagnosis

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and post-operative notes are essential for accurate coding.

Common Clinical Scenarios

Fracture repair surgeries, post-operative follow-ups, and management of complications.

Billing Considerations

Ensure documentation reflects the complexity of the fracture and any associated procedures performed.

Physical Therapy

Documentation Requirements

Progress notes detailing rehabilitation goals, treatment modalities, and patient response.

Common Clinical Scenarios

Rehabilitation following surgical repair of humeral fractures.

Billing Considerations

Document functional limitations and progress towards recovery to support therapy claims.

Coding Guidelines

Inclusion Criteria

Use S42.322 When
  • Follow official ICD
  • CM guidelines for coding fractures, including the need to specify laterality and the type of fracture
  • Ensure compliance with guidelines regarding the use of additional codes for associated conditions

Exclusion Criteria

Do NOT use S42.322 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

24500CPT Code

Closed treatment of humeral shaft fracture

Clinical Scenario

Used when a closed reduction is performed for a displaced fracture.

Documentation Requirements

Operative report detailing the procedure and any imaging used.

Specialty Considerations

Orthopedic documentation must clearly outline the fracture type and treatment.

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 details about displacement and laterality, which enhances the accuracy of patient records and billing.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, including details about displacement and laterality, which enhances the accuracy of patient records and billing.

Reimbursement & Billing Impact

billing.

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 displaced and non-displaced fractures?

Displaced fractures involve a break in the bone where the ends are not aligned, while non-displaced fractures have the bone ends still in their normal position.