Left Humeral Fracture ICD-10-CM Codes | 2025

What ICD-10 codes are used for left humeral fracture? 

Healthcare providers use the International Classification of Diseases, Tenth Revision (ICD-10) system to classify and code all diagnoses and procedures. Here are some commonly used ICD-10 codes for a fracture in the left humerus:

• S42.202A - Unspecified fracture of upper end of left humerus, initial encounter for closed fracture: This code is used for an unspecified fracture of the upper end of the left humerus, initial encounter for a closed fracture. This means the specific location or type of the fracture is not specified, but it's located at the upper end of the humerus. Use S42.202D for subsequent encounter for fractures of the left humerus. Use S42.202S for the sequela.
• S42.392A - Other fracture of shaft of left humerus, initial encounter for closed fracture: This code is used for other fractures of the shaft of the left humerus, initial encounter for a closed fracture. This code would be used when the fracture is in the middle section, or 'shaft,' of the humerus. Use S42.392D for subsequent encounters, and S42.392S for sequela.
• S42.292B - Other displaced fracture of upper end of left humerus, initial encounter for open fracture: This code is used for other displaced fractures of the upper end of the left humerus, initial encounter for an open fracture. A displaced fracture means the bone fragments are not aligned, and an open fracture refers to a break where the bone has punctured the skin. Use S42.292D for subsequent encounters, and S42.292S for sequela.
• S42.295A - Other nondisplaced fracture of upper end of left humerus, initial encounter for closed fracture: This code is used for other nondisplaced fractures of the upper end of the left humerus, initial encounter for a closed fracture. A non-displaced fracture means the bone cracks but maintains proper alignment and position. Use S42.295D for subsequent encounters, and S42.295S for sequela.
• S42.29 - Other fracture of upper end of humerus: This code is a more general one used for other fractures of the upper end of the humerus. It does not specify which arm the fracture is on or if the fracture is open or closed.
• S42.4 - Fracture of lower end of humerus: This code is used for fractures of the lower end of the humerus. Again, this doesn't specify which arm the fracture is on or whether the fracture is open or closed.

For a more detailed understanding of these codes and how they apply to patient care, this explainer video provides an excellent overview.

If you're dealing with a patient who has a humeral fracture, please note that you should use these if you're dealing with an unspecified humerus. You have to confirm the specific location first.

Which left humeral fracture ICD codes are billable?

When it comes to ICD-10 codes, not all are billable. Billable codes can be used for reimbursement purposes. Here's the billability of some common ICD-10 codes for left humeral fractures:

• S42.202A: Yes, this code is billable. It's used for an unspecified fracture of the upper end of the left humerus, an initial encounter for a closed fracture. The subsequent encounter and sequela codes for this are also billable.
• S42.392A: Yes, this code is billable. It's used for other fractures of the shaft of the left humerus, an initial encounter for a closed fracture. The subsequent encounter and sequela codes for this are also billable.
• S42.292B: Yes, this code is billable. This code is used for other displaced fractures of the upper end of the left humerus and initial encounter for an open fracture. The subsequent encounter and sequela codes for this are also billable.
• S42.295A: Yes, this code is billable. It's used for other nondisplaced fractures of the upper end of the left humerus, an initial encounter for a closed fracture. The subsequent encounter and sequela codes for this are also billable.
• S42.29: No, this code is not billable. This is a header code; more specific codes should be used for coding and billing purposes.
• S42.4: No, this code is not billable. This is also a header code; more specific codes should be used for coding and billing purposes.

Clinical information

• The humerus is the long bone in your upper arm. When broken, it's known as a humeral fracture.
• Humeral fractures can occur at different parts of the bone: the upper end (proximal humerus), the middle (the shaft), or the lower back near the elbow (distal).
• Proximal humeral fractures are most common in older people due to osteoporosis, while humeral shaft fractures are often due to high-energy trauma like a car accident or a fall from height.
• Symptoms of a humeral fracture include severe pain, swelling, bruising, and an inability to move the arm. The arm may also be deformed or shortened.
• Treatment depends on the location and type of fracture. Non-displaced fractures where the bone fragments remain aligned may be treated with a sling or brace and physical therapy.
• Displaced fractures or those involving the joint may require surgery to realign the bone fragments and possibly to insert hardware such as screws and plates.
• Recovery time varies depending on the severity of the fracture and the patient's overall health. It can take several weeks for the bone to heal and several months for the patient to regain full arm function through physical therapy.
• Complications can include nerve damage (especially to the radial nerve in shaft fractures), non-union, where the bone doesn't heal, and frozen shoulder or stiffness from prolonged immobilization.
• The ICD-10 codes used for a left humeral fracture help categorize the exact fracture type for record-keeping, statistical analysis, and insurance reimbursement purposes.

Synonyms include

• Left arm bone break
• Fracture of the left upper arm
• Break in the left humerus
• Left humeral break
• Left side humeral bone fracture
• Left humeral fracture with routine healing
• Shoulder joint fracture

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