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ICD-10 Guide
ICD-10 CodesS42.133

S42.133

Billable

Displaced fracture of coracoid process, unspecified shoulder

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

Code Description

ICD-10 S42.133 is a billable code used to indicate a diagnosis of displaced fracture of coracoid process, unspecified shoulder.

Key Diagnostic Point:

A displaced fracture of the coracoid process is a specific type of shoulder injury that occurs when the bony protrusion located on the scapula (shoulder blade) is fractured and the fragments are misaligned. This injury is often associated with trauma, such as falls or direct blows to the shoulder, and can occur in conjunction with other shoulder injuries, including dislocations and rotator cuff tears. The coracoid process serves as an attachment point for muscles and ligaments that stabilize the shoulder joint, making its integrity crucial for shoulder function. Symptoms typically include localized pain, swelling, and limited range of motion. Diagnosis is confirmed through physical examination and imaging studies, such as X-rays or CT scans, which reveal the fracture and its displacement. Treatment may involve conservative management with immobilization and physical therapy or surgical intervention to realign and stabilize the fracture, particularly in cases of significant displacement or associated injuries. Proper coding is essential for accurate billing and to reflect the complexity of the injury and its management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and associated injuries
  • Need for precise documentation of displacement
  • Differentiation from similar shoulder injuries
  • Potential for surgical intervention

Audit Risk Factors

  • Inadequate documentation of fracture type and displacement
  • Failure to document associated injuries
  • Incorrect coding of the shoulder region
  • Lack of clarity in treatment plans

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 complexity of the fracture and any surgical interventions performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessment of functional limitations and rehabilitation plans.

Common Clinical Scenarios

Patients recovering from shoulder fractures requiring rehabilitation.

Billing Considerations

Document progress and response to therapy to support ongoing treatment needs.

Coding Guidelines

Inclusion Criteria

Use S42.133 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture type, displacement, and any associated injuries
  • Include details on the mechanism of injury and treatment provided

Exclusion Criteria

Do NOT use S42.133 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

23470CPT Code

Arthroscopy, shoulder, surgical

Clinical Scenario

Used in cases where surgical intervention is required for displaced fractures.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgery and any associated procedures performed.

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, including displaced fractures of the coracoid process. This specificity aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of shoulder injuries, including displaced fractures of the coracoid process. This specificity aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of shoulder injuries, including displaced fractures of the coracoid process. This specificity aids in better tracking of treatment outcomes and resource allocation.

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 may vary based on the severity of the fracture. Options include conservative management with immobilization or surgical intervention to realign and stabilize the fracture.