ICD-10-CM Billable Code

S42.45

Fracture of lateral condyle of humerus

Clinical Classification Guidelines

Inclusion Terms

  • Fracture of capitellum of humerus

Medical Intelligence & Overview

A fracture of the lateral condyle of the humerus involves a break in the outer part of the lower end of the upper arm bone. This type of fracture often affects children and adolescents, though it can also occur in adults. Being a specific break in a crucial area of the elbow joint, it can impact arm movement and stability if not properly treated. The fracture is classified under ICD-10 code S42.45 and is sometimes referred to as a fracture of the capitellum of the humerus, highlighting its location at the upper arm bone's lateral condyle.

Causes & Symptoms

Clinical Causes: Falls onto an outstretched hand or directly onto the elbow Sports injuries, especially in activities involving falls or impacts Trauma resulting from car accidents or high-impact falls

Key Symptoms: Sudden pain at the outer part of the elbow Swelling around the elbow joint Limited range of motion or difficulty moving the arm Tenderness when touching the area Visible deformity in severe cases

Diagnostic & Treatment

Diagnosis Path: Diagnosing a fracture of the lateral condyle involves a combination of medical history assessment, physical examination, and imaging tests. X-rays are the primary method used to confirm the presence and extent of the fracture. In some cases, additional imaging, such as MRI or CT scans, may be necessary to assess the severity and whether the fracture has involved the joint surface or caused displacement. The physician will evaluate the alignment of bone fragments and consider the patient's mobility and pain levels.

Treatment Protocols: Treatment options vary based on the fracture's severity and displacement. They 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 S42.45 a billable ICD-10 code?
Yes, S42.45 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report S42.45?
Clinical documentation must specify the nature of Fracture of lateral condyle of humerus and any associated comorbidities for accurate reporting.

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