ICDwise
S42 ⚠ Non-billable

Fracture of shoulder and upper arm

ICD-10-CM · FY2026 · Injury, Poisoning and Certain Other Consequences of External Causes

Code
S42
System
ICD-10-CM
Billable
No — use specific code
Effective
FY2026
Chapter
Injury, Poisoning and Certain Other Consequences of External Causes
Source
CMS / CDC NCHS
⚠ Verify before billing. Confirm against the current CMS/NCHS ICD-10-CM files and your payer's rules before claims submission.

Official coding notes

From CMS's ICD-10-CM Tabular List.

Excludes1 — never code together
  • traumatic amputation of shoulder and upper arm (S48.-)
Excludes2 — not included here, but may code together
  • periprosthetic fracture around internal prosthetic shoulder joint (M97.3)
7th character
  • The appropriate 7th character is to be added to all codes from category S42
Note
  • A fracture not indicated as displaced or nondisplaced should be coded to displaced
  • A fracture not indicated as open or closed should be coded to closed

Frequently asked questions

What is ICD-10 code S42?
ICD-10-CM code S42 represents Fracture of shoulder and upper arm. It is a non-billable header code requiring a more specific subcategory in the Injury, Poisoning and Certain Other Consequences of External Causes chapter, effective October 1, 2025 – September 30, 2026.
Is S42 billable?
No. S42 is a non-billable header. Select a more specific subcategory for claims submission.
What chapter is S42 in?
S42 belongs to the Injury, Poisoning and Certain Other Consequences of External Causes chapter (S00–T88) of ICD-10-CM.

Related codes in the S42 category

S42.0 Fracture of clavicle Non-billable S42.00 Fracture of unspecified part of clavicle Non-billable S42.01 Fracture of sternal end of clavicle Non-billable S42.001 Fracture of unspecified part of right clavicle Non-billable S42.002 Fracture of unspecified part of left clavicle Non-billable S42.009 Fracture of unspecified part of unspecified clavicle Non-billable S42.011 Anterior displaced fracture of sternal end of right clavicle Non-billable S42.012 Anterior displaced fracture of sternal end of left clavicle Non-billable

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