ICD-10-CM Billable Code

S42.255

Nondisplaced fracture of greater tuberosity of left humerus

Clinical Classification Guidelines

Medical Intelligence & Overview

A nondisplaced fracture of the greater tuberosity of the left humerus involves a break in the upper part of the upper arm bone (humerus), specifically at the greater tuberosity, without the bone fragments shifting out of their normal position. This injury commonly occurs due to trauma, such as falls or direct blows, and requires appropriate medical assessment and treatment to ensure proper healing and restore function.

Causes & Symptoms

Clinical Causes: Trauma from a fall onto the shoulder or outstretched hand Direct blow to the shoulder area during an accident or sports injury High-impact incidents such as motor vehicle accidents Repetitive stress or overuse in certain activities, though less common

Key Symptoms: Localized pain around the shoulder and upper arm Tenderness when touching the area of the greater tuberosity Swelling and bruising around the shoulder Difficulty lifting or moving the arm Limited range of motion due to pain or discomfort Weakness in the shoulder and arm

Diagnostic & Treatment

Diagnosis Path: Diagnosis typically involves a thorough physical examination by a healthcare professional, who assesses pain, tenderness, swelling, and movement limitations. Imaging tests such as X-rays are essential to confirm the presence of a fracture, determine its exact location, and ascertain that it is nondisplaced. In some cases, CT scans may be employed for detailed visualization if necessary.

Treatment Protocols: Treatment aims to promote healing and restore shoulder function. Options 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 S42.255 a billable ICD-10 code?
Yes, S42.255 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report S42.255?
Clinical documentation must specify the nature of Nondisplaced fracture of greater tuberosity of left humerus and any associated comorbidities for accurate reporting.

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