S42.2
Non-Billable

Fracture of upper end of humerus

Non-Billable / Non-Specific Code

What is Fracture of upper end of humerus?

ICD-10-CM S42.2 is the diagnosis code for Fracture of upper end of humerus. This code falls under the section "Injuries to the shoulder and upper arm" within Chapter 19 — Injury, poisoning and certain other consequences of external causes (S00-T88). It is a non-billable/non-specific ICD-10-CM code that should not be used for reimbursement. A more specific sub-code is required for billing. Medical coders and healthcare providers use this code to document and classify diagnoses in electronic health records, insurance claims, and clinical databases.

💡 Inclusions
â„šī¸ Excludes2

Coding Guidelines for S42.2

✅ This Code Includes

  • Fracture of proximal end of humerus

â„šī¸ Type 2 Excludes (Code separately if applicable)

The following conditions are not included in S42.2. If the patient has both, code each condition separately:

  • fracture of shaft of humerus (S42.3-)
  • physeal fracture of upper end of humerus (S49.0-)

ICD-10-CM Code Hierarchy

Understanding where S42.2 sits in the ICD-10-CM classification helps ensure proper coding:

Sub-Codes 9 entries
S42.20Unspecified fracture of upper end of humerusNon-BillableS42.201Unspecified fracture of upper end of right humerusBillableS42.202Unspecified fracture of upper end of left humerusBillableS42.209Unspecified fracture of upper end of unspecified humerusBillableS42.21Unspecified fracture of surgical neck of humerusNon-BillableS42.211Unspecified displaced fracture of surgical neck of right humerusBillableS42.212Unspecified displaced fracture of surgical neck of left humerusBillableS42.213Unspecified displaced fracture of surgical neck of unspecified humerusBillableS42.214Unspecified nondisplaced fracture of surgical neck of right humerusBillableS42.215Unspecified nondisplaced fracture of surgical neck of left humerusBillableS42.216Unspecified nondisplaced fracture of surgical neck of unspecified humerusBillableS42.222-part fracture of surgical neck of humerusNon-BillableS42.2212-part displaced fracture of surgical neck of right humerusBillableS42.2222-part displaced fracture of surgical neck of left humerusBillableS42.2232-part displaced fracture of surgical neck of unspecified humerusBillableS42.2242-part nondisplaced fracture of surgical neck of right humerusBillableS42.2252-part nondisplaced fracture of surgical neck of left humerusBillableS42.2262-part nondisplaced fracture of surgical neck of unspecified humerusBillableS42.233-part fracture of surgical neck of humerusNon-BillableS42.2313-part fracture of surgical neck of right humerusBillableS42.2323-part fracture of surgical neck of left humerusBillableS42.2393-part fracture of surgical neck of unspecified humerusBillableS42.244-part fracture of surgical neck of humerusNon-BillableS42.2414-part fracture of surgical neck of right humerusBillableS42.2424-part fracture of surgical neck of left humerusBillableS42.2494-part fracture of surgical neck of unspecified humerusBillableS42.25Fracture of greater tuberosity of humerusNon-BillableS42.251Displaced fracture of greater tuberosity of right humerusBillableS42.252Displaced fracture of greater tuberosity of left humerusBillableS42.253Displaced fracture of greater tuberosity of unspecified humerusBillableS42.254Nondisplaced fracture of greater tuberosity of right humerusBillableS42.255Nondisplaced fracture of greater tuberosity of left humerusBillableS42.256Nondisplaced fracture of greater tuberosity of unspecified humerusBillableS42.26Fracture of lesser tuberosity of humerusNon-BillableS42.261Displaced fracture of lesser tuberosity of right humerusBillableS42.262Displaced fracture of lesser tuberosity of left humerusBillableS42.263Displaced fracture of lesser tuberosity of unspecified humerusBillableS42.264Nondisplaced fracture of lesser tuberosity of right humerusBillableS42.265Nondisplaced fracture of lesser tuberosity of left humerusBillableS42.266Nondisplaced fracture of lesser tuberosity of unspecified humerusBillableS42.27Torus fracture of upper end of humerusNon-BillableS42.271Torus fracture of upper end of right humerusBillableS42.272Torus fracture of upper end of left humerusBillableS42.279Torus fracture of upper end of unspecified humerusBillableS42.29Other fracture of upper end of humerusNon-BillableS42.291Other displaced fracture of upper end of right humerusBillableS42.292Other displaced fracture of upper end of left humerusBillableS42.293Other displaced fracture of upper end of unspecified humerusBillableS42.294Other nondisplaced fracture of upper end of right humerusBillableS42.295Other nondisplaced fracture of upper end of left humerusBillableS42.296Other nondisplaced fracture of upper end of unspecified humerusBillable
Related Codes

Frequently Asked Questions

Is S42.2 a billable ICD-10-CM code?

No, S42.2 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.

What does S42.2 mean?

S42.2 is the ICD-10-CM diagnosis code for "Fracture of upper end of humerus". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.

What is the parent code of S42.2?

The parent code of S42.2 is S42 ("Fracture of shoulder and upper arm"). S42.2 provides a more specific classification within this category.

What section is S42.2 in?

S42.2 is located in Section S40-S49 — "Injuries to the shoulder and upper arm" within Chapter 19 of the ICD-10-CM Tabular List.

What are the sub-codes of S42.2?

S42.2 has 9 sub-code(s) that provide more specific detail: S42.20, S42.21, S42.22, S42.23, S42.24 and more.

When should I use S42.2?

Use S42.2 when the patients documented diagnosis matches "Fracture of upper end of humerus" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.

People Also Ask

What is the ICD-10 code for Fracture of upper end of humerus?

The ICD-10-CM code for Fracture of upper end of humerus is S42.2.

Can S42.2 be used for primary diagnosis?

No, S42.2 is non-billable. Use a more specific sub-code for primary diagnosis billing.

What chapter is S42.2 in?

S42.2 is in Chapter 19 of the ICD-10-CM Tabular List.

Is S42.2 valid for 2026?

Yes, S42.2 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.

See Also

← PreviousS42.199Fracture of other part of scapula, unspecified shoulderNext →S42.20Unspecified fracture of upper end of humerus
Code Details
S42.2
Fracture of upper end of humerus
Non-Billable / Non-Specific Code
19 — Injury, poisoning and certain other consequences of external causes (S00-T88)
S40-S49 — Injuries to the shoulder and upper arm
2026 ICD-10-CM