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S42.191 vs S42.192

S42.191 (Fracture of other part of scapula, right shoulder) compared with S42.192 (Fracture of other part of scapula, left shoulder), from the official CMS tabular data. S42.191 and S42.192 code the same condition on opposite sides. MedCoder-derived

Relationship

Review

Laterality relationship

S42.191
Right
Fracture of other part of scapula, right shoulder
S42.192
Left
Fracture of other part of scapula, left shoulder

Same condition; these differ only in which side is documented.

These codes share a category and title and differ only in the side affected. The documentation decides which applies, and a bilateral code is reported only where the code set provides one.

Source: ICD-10-CM tabular list (laterality variant derived from the code title)

Can these codes be reported together?

Same condition, opposite side. S42.191 and S42.192 name the same condition on opposite sides of the body.

Same category and title, differing only in which side is affected — the documentation decides which one applies, and a bilateral code is reported only where the code set provides one.

Side by side

S42.191Fracture of other part of scapula, right shoulderS42.192Fracture of other part of scapula, left shoulder
Billing statusNon-billable header

Report instead: S42.191A, S42.191B, S42.191D, S42.191G, S42.191K

Non-billable header

Report instead: S42.192A, S42.192B, S42.192D, S42.192G, S42.192K

ClassificationS00-T88 — Injury, poisoning and certain other consequences of external causesS00-T88 — Injury, poisoning and certain other consequences of external causes
DefinitionFracture of other part of scapula, right shoulder is a non-billable ICD-10-CM category code (S42.191).Fracture of other part of scapula, left shoulder is a non-billable ICD-10-CM category code (S42.192).
7th characterThe appropriate 7th character is to be added to all codes from category S42The 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