ICD-10-CM Billable Code

S42.266

Nondisplaced fracture of lesser tuberosity of unspecified humerus

Clinical Classification Guidelines

Medical Intelligence & Overview

A nondisplaced fracture of the lesser tuberosity of the humerus is a specific type of shoulder injury where a small fragment of bone at the lesser tuberosity—an important part of the upper arm bone (humerus)—is broken but remains in its normal position. This condition often results from trauma or a sudden impact and can cause shoulder pain and limited movement. Recognizing this injury is essential for appropriate treatment and recovery.

Causes & Symptoms

Clinical Causes: Direct blow or trauma to the shoulder region Falls onto an outstretched arm or shoulder Sports injuries involving contact or falling Sudden forceful movements causing strain Bone weakness due to osteoporosis or aging

Key Symptoms: Pain localized over the inner shoulder area Swelling or tenderness around the shoulder Limited range of motion and difficulty moving the shoulder Weakness in the arm or shoulder Possible bruising or discoloration Discomfort exacerbated by certain movements or shoulder rotations

Diagnostic & Treatment

Diagnosis Path: Diagnosing this type of fracture involves a detailed physical examination and imaging tests. X-rays are the primary tool used to visualize the bone and confirm the fracture, particularly to determine whether the fracture is displaced or nondisplaced. In some cases, MRI or CT scans may be utilized for a more detailed view of the soft tissues and bone structure. The healthcare provider will assess symptoms and imaging results to establish an accurate diagnosis.

Treatment Protocols: Immobilization using a sling or shoulder brace to restrict movement and prevent further injury Rest and activity modification during the initial healing phase Pain management with medications as recommended by a healthcare provider Physical therapy and rehabilitation exercises to regain strength and mobility once healing progresses In rare cases, surgical intervention may be necessary if there are other complications or associated injuries Follow-up imaging to monitor healing progress

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 S42.266 a billable ICD-10 code?
Yes, S42.266 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report S42.266?
Clinical documentation must specify the nature of Nondisplaced fracture of lesser tuberosity of unspecified humerus and any associated comorbidities for accurate reporting.

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