ICD-10-CM Billable Code

S42.435

Nondisplaced fracture (avulsion) of lateral epicondyle of left humerus

Clinical Classification Guidelines

Medical Intelligence & Overview

A nondisplaced fracture of the lateral epicondyle of the left humerus is a specific type of bone injury that involves a small break at the outer part of the upper arm bone near the elbow. This condition is often caused by a direct blow or a fall and is characterized by the crack in the bone without any displacement of bone fragments. It is classified under ICD-10 code S42.435, which helps healthcare providers code and document this injury accurately for diagnosis, treatment, and insurance purposes.

Causes & Symptoms

Clinical Causes: Direct trauma or blow to the outer side of the elbow Falls onto an outstretched hand that transmits force to the elbow Sports injuries, especially contact sports or falls during athletic activities Accidental impacts during activities involving arm movement Overuse injuries leading to avulsion where a ligament or tendon pulls a fragment of bone away

Key Symptoms: Pain localized on the outer part of the elbow Swelling and tenderness in the affected area Difficulty in moving the elbow or gripping objects Possible bruising around the elbow Minor deformity if swelling makes the fracture more apparent, though no significant misalignment occurs in nondisplaced fractures

Diagnostic & Treatment

Diagnosis Path: Diagnosis typically involves a physical examination by a healthcare professional, who assesses swelling, tenderness, and range of motion. Imaging studies such as X-rays are essential to confirm the fracture and to verify that it is nondisplaced, meaning the broken bone has not shifted out of its normal position. In some cases, additional imaging like CT scans may be used for a more detailed view.

Treatment Protocols: Management of a nondisplaced fracture of the lateral epicondyle generally focuses on pain relief, immobilization, and promoting healing. Treatment 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 S42.435 a billable ICD-10 code?
Yes, S42.435 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report S42.435?
Clinical documentation must specify the nature of Nondisplaced fracture (avulsion) of lateral epicondyle of left humerus and any associated comorbidities for accurate reporting.

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