Left Humeral Fracture ICD-10-CM Codes | 2023
Discover the commonly used ICD-10 codes for Left Humeral Fracture, their clinical implications, and billability.
Fact Checked by Ericka Pingol.
What ICD-10 Codes are Used for Left Humeral Fracture?
The International Classification of Diseases, Tenth Revision (ICD-10) system healthcare providers use to classify and code all diagnoses and procedures. Here are some commonly used ICD-10 codes for a fracture in the left humerus:
- ICD-10 Code S42.202A: 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.
- ICD-10 Code S42.392A: 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.
- ICD-10 Code S42.292B: 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.
- ICD-10 Code S42.295A: 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.
- ICD-10 Code S42.29: 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.
- ICD-10 Code S42.4: 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.
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:
- ICD-10 Code 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.
- ICD-10 Code 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.
- ICD-10 Code 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.
- ICD-10 Code 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.
- ICD-10 Code S42.29: No, this code is not billable. This is a header code; more specific codes should be used for coding and billing purposes.
- ICD-10 Code 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 inability to move the arm. There may also be a visible deformity or shortening of the arm.
- 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 to regain full arm function through physical therapy.
- Complications can include nerve damage (especially 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
Commonly asked questions
A Left Humeral Fracture ICD code is used when a patient presents with a fracture in the left humerus. This can occur for various reasons, such as trauma, falls, or underlying bone weakness. The specific ICD-10 code used will depend on the exact type and location of the fracture.
Yes, most Left Humeral Fracture ICD-10 codes are billable. They can be used for reimbursement from insurance companies. However, some "header" codes that provide broad classifications of conditions are not billable. Always consult with a certified medical coder or billing specialist for accurate information.
The treatment for a left humeral fracture depends on the specific type and location of the fracture. Non-displaced fractures may be treated with a sling or brace and physical therapy, while displaced fractures or fractures involving the joint might require surgical intervention.
A diagnosis code for a Left Humeral Fracture provides a standardized definition of the condition. It indicates that the patient has a fracture in the humerus bone of the left arm. The specific code used gives more detail about the type and location of this fracture. These codes are used for record-keeping, statistical analysis, and insurance billing.
