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ICD-10 Guide
ICD-10 CodesS42.131

S42.131

Billable

Displaced fracture of coracoid process, right shoulder

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

Code Description

ICD-10 S42.131 is a billable code used to indicate a diagnosis of displaced fracture of coracoid process, right shoulder.

Key Diagnostic Point:

A displaced fracture of the coracoid process of the scapula is a specific type of shoulder injury that occurs when the coracoid process, a small hook-like bony projection on the scapula, is fractured due to trauma. This injury is often associated with shoulder dislocations, particularly anterior dislocations, and can occur in high-impact sports or accidents. The coracoid process serves as an attachment point for several muscles and ligaments, including the pectoralis minor and the coracobrachialis. Symptoms typically include localized pain, swelling, and limited range of motion in the shoulder. Diagnosis is usually confirmed through imaging studies such as X-rays or CT scans. Treatment may involve conservative management with rest and physical therapy or surgical intervention if the fracture is significantly displaced. Surgical options may include fixation with screws or plates to stabilize the fracture and restore function. Proper coding of this condition is essential for accurate billing and treatment tracking.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of specific anatomical terminology
  • Differentiation from similar shoulder injuries
  • Need for precise documentation of displacement
  • Potential for associated injuries complicating coding

Audit Risk Factors

  • Inadequate documentation of the fracture type and displacement
  • Failure to document associated injuries or conditions
  • Misclassification of the fracture location
  • Inconsistent use of imaging results in documentation

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging results, and post-operative care plans.

Common Clinical Scenarios

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

Billing Considerations

Ensure documentation reflects the mechanism of injury and any associated injuries.

Physical Therapy

Documentation Requirements

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

Common Clinical Scenarios

Rehabilitation following surgical repair of the coracoid process.

Billing Considerations

Documenting the patient's response to therapy and any complications.

Coding Guidelines

Inclusion Criteria

Use S42.131 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture's displacement and any associated injuries
  • Include details from imaging studies and treatment plans

Exclusion Criteria

Do NOT use S42.131 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopy, shoulder, surgical

Clinical Scenario

Used for surgical repair of the coracoid process fracture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons should ensure all surgical details are documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of shoulder injuries, improving the accuracy of billing and treatment tracking for displaced fractures.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of shoulder injuries, improving the accuracy of billing and treatment tracking for displaced fractures.

Reimbursement & Billing Impact

billing and treatment tracking for displaced fractures.

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 primary treatment for a displaced fracture of the coracoid process?

Treatment typically involves surgical fixation if the fracture is significantly displaced, along with physical therapy for rehabilitation.