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S42.309B

Unspecified fracture of shaft of humerus, unspecified arm, initial encounter for open fracture

Billable FY2026 2025-10-01 → 2026-09-30
This is the unspecified option. 6 more specific codes sit alongside it. Worth checking whether the documentation supports one of them.
Exclusions 10 never code together
S42code
Excludes1
  • traumatic amputation of shoulder and upper arm (S48.-)S48.-
Excludes2
  • periprosthetic fracture around internal prosthetic shoulder joint (M97.3)M97.3
S42.3code
Excludes2
  • physeal fractures of upper end of humerus (S49.0-)S49.0-
  • physeal fractures of lower end of humerus (S49.1-)S49.1-
S40-S49block
Excludes2
  • burns and corrosions (T20-T32)T20-T32
  • frostbite (T33-T34)T33-T34
  • injuries of elbow (S50-S59)S50-S59
  • insect bite or sting, venomous (T63.4)T63.4
S00-T88chapter
Excludes2

Excludes1 — never code together. The excluded condition and this one are mutually exclusive.

Excludes2 — not included here, but the patient may have both. Code both when documented.

7th character 7
A initial encounter for closed fracture
B initial encounter for open fracture this code
D subsequent encounter for fracture with routine healing
G subsequent encounter for fracture with delayed healing
K subsequent encounter for fracture with nonunion
P subsequent encounter for fracture with malunion
S sequela
Instructional notes 9
S42code
Notes
  • A fracture not indicated as displaced or nondisplaced should be coded to displaced
  • A fracture not indicated as open or closed should be coded to closed
S42.3code
Inclusion terms
  • Fracture of humerus NOS
  • Fracture of upper arm NOS
S40-S49block
Includes
  • injuries of axilla
  • injuries of scapular region
S00-T88chapter
Notes
  • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
  • The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.
Use additional code
  • code to identify any retained foreign body, if applicable (Z18.-)Z18.-
Index entries leading here 1
  • Fracture, traumatic (abduction) (adduction) (separation) T14.8
Alongside this code 6 same parent — S42.309
S42.309A Unsp fracture of shaft of humerus, unsp arm, init S42.309D Unsp fx shaft of humerus, unsp arm, subs for fx w routn heal S42.309G Unsp fx shaft of humerus, unsp arm, subs for fx w delay heal S42.309K Unsp fx shaft of humerus, unsp arm, subs for fx w nonunion S42.309P Unsp fx shaft of humerus, unsp arm, subs for fx w malunion S42.309S Unsp fracture of shaft of humerus, unspecified arm, sequela
Additional references
AHA Coding Clinic® Licence required

Official coding advice for this code. Published by the American Hospital Association. Not included in this installation.

Risk adjustment

Maps to no condition category in any loaded model.

Presence is a property of the code. Untick a model to hide it everywhere.

This code

Billable
yes
Code set
FY2026
Parent
S42.309
Block
S40-S49
Siblings
6

Present FY2024–FY2027.