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Compare/S42 vs S50

S42 vs S50

S42 (Fracture of shoulder and upper arm) compared with S50 (Superficial injury of elbow and forearm), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Can these codes be reported together?

Yes, when both are documented. S42 carries an Excludes2 note covering S50: “injuries of elbow (S50-S59)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

S42Fracture of shoulder and upper armS50Superficial injury of elbow and forearm
Billing statusNon-billable header

Report instead: S42.001A, S42.001B, S42.001D, S42.001G, S42.001K

Non-billable header

Report instead: S50.00XA, S50.00XD, S50.00XS, S50.01XA, S50.01XD

ClassificationS00-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)
DefinitionFracture of shoulder and upper arm is a non-billable ICD-10-CM category code (S42).Superficial injury of elbow and forearm is a non-billable ICD-10-CM category code (S50).
7th characterThe appropriate 7th character is to be added to all codes from category S42The appropriate 7th character is to be added to each code from category S50
Includes
injuries of axilla
injuries of scapular region

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources