S42 vs S48
S42 (Fracture of shoulder and upper arm) compared with S48 (Traumatic amputation of shoulder and upper arm), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. S42 carries an Excludes1 note covering S48: “traumatic amputation of shoulder and upper arm (S48.-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| S42Fracture of shoulder and upper arm | S48Traumatic amputation of shoulder and upper arm | |
|---|---|---|
| Billing status | Non-billable header Report instead: S42.001A, S42.001B, S42.001D, S42.001G, S42.001K | Non-billable header Report instead: S48.011A, S48.011D, S48.011S, S48.012A, S48.012D |
| Classification | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Fracture of shoulder and upper arm is a non-billable ICD-10-CM category code (S42). | Traumatic amputation of shoulder and upper arm is a non-billable ICD-10-CM category code (S48). |
| 7th character | The appropriate 7th character is to be added to all codes from category S42 | The appropriate 7th character is to be added to each code from category S48 |
| Includes | injuries of axilla injuries of scapular region | injuries of axilla injuries of scapular region An amputation not identified as partial or complete should be coded to complete |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources