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ICD-10 Guide
ICD-10 CodesS42.335

S42.335

Billable

Nondisplaced oblique fracture of shaft of humerus, left arm

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

Code Description

ICD-10 S42.335 is a billable code used to indicate a diagnosis of nondisplaced oblique fracture of shaft of humerus, left arm.

Key Diagnostic Point:

A nondisplaced oblique fracture of the shaft of the humerus occurs when there is a break in the bone that does not result in the bone fragments being misaligned. This type of fracture is characterized by a diagonal break across the shaft of the humerus, which is the long bone of the upper arm. Such fractures can result from various mechanisms, including falls, direct blows, or sports injuries. Patients may present with pain, swelling, and limited range of motion in the affected arm. Diagnosis is typically confirmed through imaging studies such as X-rays, which reveal the fracture pattern. Treatment often involves conservative management, including immobilization with a sling or brace, followed by physical therapy to restore function. In some cases, surgical intervention may be necessary if the fracture is unstable or if there are associated injuries to surrounding structures. Understanding the nuances of this fracture type is crucial for accurate coding and appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between displaced and nondisplaced fractures
  • Understanding the specific location of the fracture (shaft vs. proximal/distal)
  • Identifying associated injuries (e.g., rotator cuff tears)
  • Variability in treatment approaches (surgical vs. conservative)

Audit Risk Factors

  • Inadequate documentation of fracture type and location
  • Failure to document associated injuries or complications
  • Misclassification of fracture as displaced
  • Lack of imaging reports in the medical record

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and follow-up notes are essential.

Common Clinical Scenarios

Fractures resulting from trauma, sports injuries, or falls.

Billing Considerations

Ensure accurate documentation of fracture type and treatment plan.

Physical Therapy

Documentation Requirements

Progress notes detailing range of motion, strength assessments, and functional outcomes.

Common Clinical Scenarios

Rehabilitation following humeral fractures or surgical repairs.

Billing Considerations

Document the patient's response to therapy and any modifications to the treatment plan.

Coding Guidelines

Inclusion Criteria

Use S42.335 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture type, location, and any associated injuries

Exclusion Criteria

Do NOT use S42.335 When
  • Exclude codes for displaced fractures or other specific conditions that do not match the clinical scenario

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 rationale for surgery.

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 patient records and treatment plans. S42.335 provides a clear distinction between nondisplaced and displaced fractures, which is crucial 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 patient records and treatment plans. S42.335 provides a clear distinction between nondisplaced and displaced fractures, which is crucial 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 a nondisplaced and displaced fracture?

A nondisplaced fracture means the bone cracks but maintains its proper alignment, while a displaced fracture involves a break where the bone fragments are misaligned.