ICD-10-CM Billable Code

S42.254

Nondisplaced fracture of greater tuberosity of right humerus

Clinical Classification Guidelines

Medical Intelligence & Overview

A nondisplaced fracture of the greater tuberosity of the right humerus involves a break in the upper part of the upper arm bone (humerus), specifically at the point where important shoulder muscles attach. In this type of fracture, the bone cracks but remains aligned, which typically results in less damage to surrounding tissues and may lead to a faster recovery process.

Causes & Symptoms

Clinical Causes: Direct trauma or impact to the shoulder area, such as a fall directly onto the shoulder Sports injuries involving falls or collisions Accidental trauma during activities or accidents that exert force on the shoulder Falls from a height or onto an outstretched arm Repetitive stress or overuse, although less common for this specific fracture

Key Symptoms: Pain localized at the top of the shoulder or upper arm Swelling around the shoulder area Limited range of motion in the shoulder, especially when trying to lift or rotate the arm Tenderness when touching the outer shoulder Possible bruising around the shoulder Weakness in the shoulder or arm Discomfort that worsens with shoulder movement or pressure

Diagnostic & Treatment

Diagnosis Path: To diagnose this type of fracture, healthcare professionals typically perform a physical examination and review the patient's medical history. Imaging tests are essential for confirming the diagnosis:

Treatment Protocols: Treatment options for a nondisplaced fracture of the greater tuberosity generally aim to promote healing while maintaining shoulder function. Common approaches 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 S42.254 a billable ICD-10 code?
Yes, S42.254 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report S42.254?
Clinical documentation must specify the nature of Nondisplaced fracture of greater tuberosity of right humerus and any associated comorbidities for accurate reporting.

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