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ICD-10 Guide
ICD-10 CodesS42.324

S42.324

Billable

Nondisplaced transverse fracture of shaft of humerus, right arm

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

Code Description

ICD-10 S42.324 is a billable code used to indicate a diagnosis of nondisplaced transverse fracture of shaft of humerus, right arm.

Key Diagnostic Point:

A nondisplaced transverse fracture of the shaft of the humerus occurs when the bone is broken across its width but remains aligned, meaning the fracture fragments do not shift from their original position. This type of fracture is often the result of direct trauma, such as a fall or a sports injury. Patients may present with pain, swelling, and limited range of motion in the shoulder and arm. Diagnosis typically involves physical examination and imaging studies, such as X-rays, to confirm the fracture type and assess for any associated injuries. Treatment usually involves conservative management, including immobilization with a sling or brace, pain management, and physical therapy to restore function. Surgical intervention may be required if there are complications or if the fracture does not heal properly. Understanding the nuances of this fracture type is crucial for accurate coding and appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between displaced and nondisplaced fractures
  • Understanding the anatomical location of the humerus
  • Identifying associated injuries or complications
  • Documentation of the mechanism of injury

Audit Risk Factors

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

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and follow-up notes are essential for accurate coding.

Common Clinical Scenarios

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

Billing Considerations

Ensure that all surgical procedures performed are documented, including any fixation methods used.

Physical Therapy

Documentation Requirements

Progress notes detailing the patient's rehabilitation progress and response to treatment.

Common Clinical Scenarios

Patients undergoing rehabilitation post-fracture to regain strength and mobility.

Billing Considerations

Document specific therapeutic interventions and patient outcomes to support the need for ongoing therapy.

Coding Guidelines

Inclusion Criteria

Use S42.324 When
  • Follow the official ICD
  • CM guidelines for coding fractures, including the need to specify laterality and the type of fracture
  • Ensure that documentation supports the diagnosis and treatment plan

Exclusion Criteria

Do NOT use S42.324 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 needed for associated injuries.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the necessity for surgery based on the fracture type.

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. S42.324 provides clarity in documenting nondisplaced fractures, which aids in better patient management.

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. S42.324 provides clarity in documenting nondisplaced fractures, which aids in better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of patient records and treatment plans. S42.324 provides clarity in documenting nondisplaced fractures, which aids in better patient management.

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.