S42.191K vs S42.199K

S42.191K (Fracture of other part of scapula, right shoulder, subsequent encounter for fracture with nonunion) compared with S42.199K (Fracture of other part of scapula, unspecified shoulder, subsequent encounter for fracture with nonunion), from the official CMS tabular data. S42.191K and S42.199K code the same condition on opposite sides. MedCoder-derived

Relationship

Review

Laterality relationship

S42.191K

Right

Fracture of other part of scapula, right shoulder, subsequent encounter for fracture with nonunion

↔

S42.199K

Unspecified

Fracture of other part of scapula, unspecified shoulder, subsequent encounter for fracture with nonunion

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. S42.191K and S42.199K 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

	S42.191KFracture of other part of scapula, right shoulder, subsequent encounter for fracture with nonunion	S42.199KFracture of other part of scapula, unspecified shoulder, subsequent encounter for fracture with nonunion
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	Fracture of other part of scapula, right shoulder, subsequent encounter for fracture with nonunion is a billable ICD-10-CM diagnosis code (S42.191K).	Fracture of other part of scapula, unspecified shoulder, subsequent encounter for fracture with nonunion is a billable ICD-10-CM diagnosis code (S42.199K).
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

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