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ICD-10 Guide
ICD-10 CodesS42.011

S42.011

Billable

Anterior displaced fracture of sternal end of right clavicle

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

Code Description

ICD-10 S42.011 is a billable code used to indicate a diagnosis of anterior displaced fracture of sternal end of right clavicle.

Key Diagnostic Point:

The anterior displaced fracture of the sternal end of the right clavicle is a specific type of fracture that occurs at the junction where the clavicle meets the sternum. This injury is often the result of direct trauma, such as a fall or a collision, and can lead to significant pain, swelling, and limited range of motion in the shoulder. Clinically, patients may present with visible deformity, tenderness over the fracture site, and difficulty in performing overhead activities. The anterior displacement indicates that the fractured segment has moved forward, which can complicate the healing process and may require surgical intervention. Diagnosis typically involves physical examination and imaging studies, such as X-rays or CT scans, to assess the fracture's alignment and displacement. Treatment options vary based on the severity of the fracture and may include conservative management with immobilization or surgical repair to restore anatomical alignment and function. Proper coding is essential for accurate billing and to ensure appropriate treatment protocols are followed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the fracture location (sternal end of the clavicle)
  • Need for accurate documentation of displacement
  • Differentiation from other types of clavicular fractures
  • Potential for surgical intervention and associated codes

Audit Risk Factors

  • Inadequate documentation of fracture type and displacement
  • Failure to specify laterality (right vs. left)
  • Misclassification of fracture severity
  • Lack of imaging documentation to support the diagnosis

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging reports, and follow-up assessments are necessary to support surgical interventions.

Common Clinical Scenarios

Fractures resulting from sports injuries, falls, or vehicular accidents requiring surgical fixation.

Billing Considerations

Ensure that all surgical procedures are linked to the correct diagnosis code for accurate billing.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional limitations and rehabilitation progress notes.

Common Clinical Scenarios

Patients undergoing rehabilitation post-fracture repair to regain shoulder function.

Billing Considerations

Document the patient's progress and any complications that may arise during rehabilitation.

Coding Guidelines

Inclusion Criteria

Use S42.011 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code accurately reflects the fracture's location, type, and laterality
  • Include any relevant external cause codes if applicable

Exclusion Criteria

Do NOT use S42.011 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopy, shoulder, surgical

Clinical Scenario

Used in conjunction with S42.011 when surgical intervention is required for fracture repair.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must ensure accurate linkage between the diagnosis and procedure codes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding fractures, enabling better tracking of treatment outcomes and resource allocation. S42.011 provides detailed information that can improve patient care and billing accuracy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding fractures, enabling better tracking of treatment outcomes and resource allocation. S42.011 provides detailed information that can improve patient care and billing accuracy.

Reimbursement & Billing Impact

billing accuracy.

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 S42.011 and S42.012?

S42.011 refers to an anterior displaced fracture of the sternal end of the right clavicle, while S42.012 refers to a non-displaced fracture of the same location. The distinction is crucial for treatment planning and coding accuracy.