ICD-10-CM Billable Code

S42.433

Displaced fracture (avulsion) of lateral epicondyle of unspecified humerus

Clinical Classification Guidelines

Medical Intelligence & Overview

A displaced fracture, specifically an avulsion fracture of the lateral epicondyle of the humerus, occurs when a fragment of bone at the outer part of the lower end of the upper arm bone (humerus) is pulled away from the main bone. This type of injury often results from a sudden force or trauma, such as a fall or direct blow, especially during activities that involve arm twisting or gripping. The term 'displaced' indicates that the fractured bone fragment has shifted from its original position, potentially complicating healing and requiring medical intervention.

Causes & Symptoms

Clinical Causes: Fall onto an outstretched arm Direct blow or impact to the lateral side of the elbow Repetitive stress or overuse in activities such as throwing sports Trauma from accidents or sports injuries Sudden twisting or pulling motions involving the arm

Key Symptoms: Pain around the outer part of the elbow Swelling and tenderness in the affected area Limited range of motion in the elbow Bruising or discoloration around the injury site Weakness in the forearm or hand A visible deformity or bump in severe cases

Diagnostic & Treatment

Diagnosis Path: Diagnosis typically involves a physical examination by a healthcare professional, observing for swelling, tenderness, and movement limitations. Imaging tests are crucial to confirm the fracture and its displacement. These may include:

Treatment Protocols: Management of a displaced avulsion fracture of the lateral epicondyle generally requires medical intervention, which may include:

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

Clinical Advice & FAQs

Billing Guidance

Is S42.433 a billable ICD-10 code?
Yes, S42.433 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report S42.433?
Clinical documentation must specify the nature of Displaced fracture (avulsion) of lateral epicondyle of unspecified humerus and any associated comorbidities for accurate reporting.

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