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ICD-10 Guide
ICD-10 CodesS42.025

S42.025

Billable

Nondisplaced fracture of shaft of left clavicle

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

Code Description

ICD-10 S42.025 is a billable code used to indicate a diagnosis of nondisplaced fracture of shaft of left clavicle.

Key Diagnostic Point:

A nondisplaced fracture of the shaft of the left clavicle occurs when the bone is broken but the fragments remain in alignment and do not move out of place. This type of fracture is commonly caused by direct trauma, such as a fall onto the shoulder or a sports-related injury. Patients may present with localized pain, swelling, and tenderness over the clavicle, along with limited range of motion in the shoulder. Diagnosis is typically confirmed through physical examination and imaging studies, such as X-rays. Treatment often involves conservative management, including rest, ice, immobilization with a sling, and pain management. Surgical intervention may be considered in cases where there is significant displacement or associated injuries, such as shoulder dislocations or rotator cuff tears. Understanding the implications of this fracture is crucial, as it can affect shoulder function and may lead to complications if not managed appropriately.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between displaced and nondisplaced fractures
  • Understanding associated injuries (e.g., rotator cuff tears)
  • Documentation of clinical findings and imaging results
  • Variability in treatment approaches (conservative vs. surgical)

Audit Risk Factors

  • Inadequate documentation of fracture type
  • Failure to document associated injuries
  • Misclassification of fracture displacement
  • Inconsistent coding of treatment modalities

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on fracture type, treatment plan, and follow-up care.

Common Clinical Scenarios

Fractures resulting from falls, sports injuries, or accidents.

Billing Considerations

Ensure clarity in documentation regarding the mechanism of injury and any associated conditions.

Physical Medicine and Rehabilitation

Documentation Requirements

Assessment of functional limitations and rehabilitation goals.

Common Clinical Scenarios

Patients requiring rehabilitation post-fracture for mobility and strength.

Billing Considerations

Document progress and response to therapy to support ongoing treatment.

Coding Guidelines

Inclusion Criteria

Use S42.025 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the fracture type and any associated injuries
  • Include details on the treatment plan and any surgical interventions if applicable

Exclusion Criteria

Do NOT use S42.025 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23630CPT Code

Open treatment of clavicular fracture

Clinical Scenario

Used when surgical intervention is required for a displaced fracture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons should ensure accurate coding based on surgical findings.

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. S42.025 provides a clear distinction for nondisplaced fractures, which aids in appropriate management and billing.

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. S42.025 provides a clear distinction for nondisplaced fractures, which aids in appropriate management 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 a displaced and nondisplaced fracture?

A displaced fracture involves a break where the bone fragments are misaligned, while a nondisplaced fracture means the bone remains in its normal position despite the break.