ICD-10-CM Billable Code

S42.461

Displaced fracture of medial condyle of right humerus

Clinical Classification Guidelines

Medical Intelligence & Overview

A displaced fracture of the medial condyle of the right humerus is a break in the bony prominence located on the inner side of the upper arm bone near the elbow joint. When the fracture is displaced, the broken pieces of bone are out of proper alignment, which usually requires medical intervention to ensure proper healing. The humerus is the long bone in the upper arm that connects the shoulder to the elbow, and its medial condyle plays a crucial role in elbow joint function and arm movement.

Causes & Symptoms

Clinical Causes: Falls onto an outstretched arm or direct blow to the elbow region Trauma from sports injuries, accidents, or falls High-impact injuries, such as car accidents Twisting injuries that put excessive stress on the elbow joint

Key Symptoms: Severe pain in the inner elbow or upper arm Swelling and tenderness around the elbow Visible deformity or abnormal bump at the elbow Restricted movement or inability to bend or straighten the arm Bruising around the injured area Weakness or numbness in the hand or fingers if nerves are affected

Diagnostic & Treatment

Diagnosis Path: Diagnosis typically involves a physical examination by a healthcare professional, who will assess tenderness, deformity, and range of motion. Imaging tests are essential for confirming the fracture and its displacement:

Treatment Protocols: Immobilization with a cast or splint to keep the bone in place during healing Closed reduction, a procedure to realign the broken bones without surgery, followed by immobilization Surgical intervention, such as internal fixation with pins, screws, or plates, especially if the bone fragments are significantly displaced In some cases, a period of rest and elevation to reduce swelling Physical therapy after healing to restore movement, strength, and function

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 S42.461 a billable ICD-10 code?
Yes, S42.461 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report S42.461?
Clinical documentation must specify the nature of Displaced fracture of medial condyle of right humerus and any associated comorbidities for accurate reporting.

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