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ICD-10 Guide
ICD-10 CodesS42.033

S42.033

Billable

Displaced fracture of lateral end of unspecified clavicle

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

Code Description

ICD-10 S42.033 is a billable code used to indicate a diagnosis of displaced fracture of lateral end of unspecified clavicle.

Key Diagnostic Point:

A displaced fracture of the lateral end of the clavicle typically occurs due to trauma, such as a fall or direct impact to the shoulder. This injury can lead to significant pain, swelling, and limited range of motion in the shoulder joint. The clavicle, or collarbone, connects the arm to the body and plays a crucial role in shoulder stability. Displacement refers to the misalignment of the bone fragments, which can complicate healing and may require surgical intervention. Symptoms often include tenderness at the fracture site, visible deformity, and difficulty lifting the arm. Diagnosis is usually confirmed through physical examination and imaging studies, such as X-rays. Treatment options vary based on the severity of the fracture and may include conservative management with immobilization or surgical repair to realign the bone fragments. Rehabilitation is essential for restoring function and strength to the shoulder following treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and treatment options
  • Need for precise documentation of displacement and location
  • Potential for associated injuries (e.g., rotator cuff tears)
  • Differentiation from non-displaced fractures

Audit Risk Factors

  • Inadequate documentation of fracture type and displacement
  • Failure to document associated injuries or complications
  • Incorrect coding of laterality or unspecified location
  • Lack of clarity in treatment plan and follow-up care

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

Fractures resulting from sports injuries, falls, or vehicular accidents.

Billing Considerations

Ensure documentation specifies the degree of displacement and any associated injuries.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional limitations and rehabilitation plans.

Common Clinical Scenarios

Patients recovering from surgical repair of clavicle fractures.

Billing Considerations

Document progress notes that reflect improvements in range of motion and strength.

Coding Guidelines

Inclusion Criteria

Use S42.033 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the fracture's location, type, and any associated injuries
  • displaced fractures or other shoulder injuries unless specified

Exclusion Criteria

Do NOT use S42.033 When
  • Exclude codes for non

Related ICD-10 Codes

Related CPT Codes

23630CPT Code

Open treatment of clavicular fracture

Clinical Scenario

Used when surgical intervention is performed for a displaced clavicle fracture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the specifics of the fracture and surgical technique.

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 claims and facilitating better patient management through detailed documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of claims and facilitating better patient management through detailed documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of claims and facilitating better patient management through detailed documentation.

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 S42.033 and S42.032?

S42.033 refers to a displaced fracture of the lateral end of the clavicle, while S42.032 refers to a non-displaced fracture of the same area. The distinction is crucial for treatment and coding purposes.