ICD-10-CM Billable Code

S42.251

Displaced fracture of greater tuberosity of right humerus

Clinical Classification Guidelines

Medical Intelligence & Overview

A displaced fracture of the greater tuberosity of the right humerus involves a break in the upper arm bone near the shoulder. The greater tuberosity is a prominent bump on the top of the humerus, which serves as an attachment point for shoulder muscles. When this area is fractured, especially if displaced, it can impact shoulder movement and strength. Such injuries are common in falls or direct impacts and often require prompt medical assessment and treatment to restore function and prevent complications.

Causes & Symptoms

Clinical Causes: Falls onto the shoulder or outstretched hand Direct blow to the upper arm or shoulder Trauma from sports activities or accidents History of osteoporosis increasing fracture risk Falls in elderly individuals due to balance issues

Key Symptoms: Sudden shoulder pain especially around the upper arm Swelling and tenderness over the shoulder Inability or difficulty in lifting or moving the arm Deformed appearance or abnormal bump near the shoulder Bruising around the shoulder area Limited range of motion due to pain or structural damage

Diagnostic & Treatment

Diagnosis Path: Diagnosis typically involves a detailed physical examination and imaging studies. X-rays are the primary method for confirming a fracture and assessing whether the fracture is displaced. In some cases, advanced imaging like MRI or CT scans may be performed to evaluate the extent of injury and involvement of surrounding tissues. Proper diagnosis helps determine the appropriate treatment plan and potential need for surgical intervention.

Treatment Protocols: Treatment approaches depend on the severity and displacement of the fracture. Options 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 S42.251 a billable ICD-10 code?
Yes, S42.251 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report S42.251?
Clinical documentation must specify the nature of Displaced fracture of greater tuberosity of right humerus and any associated comorbidities for accurate reporting.

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