S42.125A (Nondisplaced fracture of acromial process, left shoulder, initial encounter for closed fracture) compared with S42.125S (Nondisplaced fracture of acromial process, left shoulder, sequela), from the official CMS tabular data. S42.125A and S42.125S code the same injury at a different phase of treatment. MedCoder-derived
Same underlying diagnosis, different encounter phase.
The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.
Source: ICD-10-CM Official Guidelines, Section I.C.19.a
Same injury, other encounter phase. S42.125A and S42.125S code the same injury at a different phase of treatment, set by the 7th character.
The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.
| S42.125ANondisplaced fracture of acromial process, left shoulder, initial encounter for closed fracture | S42.125SNondisplaced fracture of acromial process, left shoulder, sequela | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | S00-T88 — Injury, poisoning and certain other consequences of external causes | S00-T88 — Injury, poisoning and certain other consequences of external causes |
| Definition | Nondisplaced fracture of acromial process, left shoulder, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S42.125A). | Nondisplaced fracture of acromial process, left shoulder, sequela is a billable ICD-10-CM diagnosis code (S42.125S). |
| 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 all codes from category S42 |
| Includes | injuries of axilla injuries of scapular region | 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