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v1.0.0
ICD-10 Guide
ICD-10 CodesS42.336

S42.336

Billable

Nondisplaced oblique fracture of shaft of humerus, unspecified arm

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

Code Description

ICD-10 S42.336 is a billable code used to indicate a diagnosis of nondisplaced oblique fracture of shaft of humerus, unspecified arm.

Key Diagnostic Point:

A nondisplaced oblique fracture of the shaft of the humerus is characterized by a fracture line that runs diagonally across the bone, without any significant displacement of the bone fragments. This type of fracture typically occurs due to a direct blow or a fall onto an outstretched arm. Patients may present with pain, swelling, and limited range of motion in the affected arm. Diagnosis is usually 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. Surgical intervention may be required in cases where the fracture is unstable or if there are associated injuries, such as nerve damage or vascular compromise. 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

  • Variability in fracture presentation and associated injuries
  • Need for precise documentation of fracture type and location
  • Differentiation from other types of humeral fractures
  • Potential for surgical intervention complicating coding

Audit Risk Factors

  • Inadequate documentation of fracture type and mechanism of injury
  • Failure to document associated injuries or complications
  • Misclassification of fracture displacement
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and post-operative notes.

Common Clinical Scenarios

Fracture repair, management of complications, and rehabilitation.

Billing Considerations

Ensure clarity on the type of fracture and any surgical interventions performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments, treatment plans, and progress notes.

Common Clinical Scenarios

Rehabilitation post-fracture, pain management, and functional assessments.

Billing Considerations

Document functional limitations and progress towards rehabilitation goals.

Coding Guidelines

Inclusion Criteria

Use S42.336 When
  • Follow official ICD
  • CM guidelines for coding fractures, including the need for specificity regarding the type and location of the fracture
  • Ensure to document the mechanism of injury and any associated conditions

Exclusion Criteria

Do NOT use S42.336 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopy, shoulder, surgical

Clinical Scenario

Used when surgical intervention is required for associated injuries.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons should ensure accurate coding based on the surgical approach.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding fractures, improving the accuracy of patient records and facilitating better treatment planning. S42.336 provides a clear distinction for nondisplaced oblique fractures, which aids in clinical decision-making.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding fractures, improving the accuracy of patient records and facilitating better treatment planning. S42.336 provides a clear distinction for nondisplaced oblique fractures, which aids in clinical decision-making.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding fractures, improving the accuracy of patient records and facilitating better treatment planning. S42.336 provides a clear distinction for nondisplaced oblique fractures, which aids in clinical decision-making.

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 displaced and nondisplaced fracture?

A displaced fracture involves a complete break in the bone where the ends are not aligned, while a nondisplaced fracture means the bone cracks but maintains its proper alignment.