ICD-10-CM Billable Code

S49.199

Other physeal fracture of lower end of humerus, unspecified arm

Clinical Classification Guidelines

Medical Intelligence & Overview

A physeal fracture at the lower end of the humerus involves a break near the growth plate of the upper arm bone. This condition typically affects children and teenagers whose long bones are still growing. The fracture occurs at the physis, the area of developing tissue near the ends of long bones. Proper diagnosis and management are essential for ensuring full recovery and normal growth.

Causes & Symptoms

Clinical Causes: Falls onto an outstretched arm Direct blow or trauma to the upper arm or elbow Sports injuries involving sudden impact Car accidents or other high-impact trauma Accidental falls from height

Key Symptoms: Pain and tenderness around the elbow or upper arm Swelling or bruising at the injury site Limited range of motion in the elbow or arm Deformity or abnormal swelling Numbness or tingling if nerves are affected Sensitivity to touch in the affected area

Diagnostic & Treatment

Diagnosis Path: Diagnosis begins with a comprehensive physical examination and a detailed medical history. Imaging tests are vital for confirming the fracture and assessing its severity. These typically include:

Treatment Protocols: The course of treatment will depend on the severity and type of the fracture. 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 S49.199 a billable ICD-10 code?
Yes, S49.199 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report S49.199?
Clinical documentation must specify the nature of Other physeal fracture of lower end of humerus, unspecified arm and any associated comorbidities for accurate reporting.

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