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S42.201 vs S42.202

S42.201 (Unspecified fracture of upper end of right humerus) compared with S42.202 (Unspecified fracture of upper end of left humerus), from the official CMS tabular data. S42.201 and S42.202 code the same condition on opposite sides.

Relationship

Review

Laterality relationship

S42.201
Right
Unspecified fracture of upper end of right humerus
S42.202
Left
Unspecified fracture of upper end of left humerus

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. S42.201 and S42.202 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

S42.201Unspecified fracture of upper end of right humerusS42.202Unspecified fracture of upper end of left humerus
Billing statusNon-billable header

Report instead: S42.201A, S42.201B, S42.201D, S42.201G, S42.201K

Non-billable header

Report instead: S42.202A, S42.202B, S42.202D, S42.202G, S42.202K

ClassificationS00-T88 — Injury, poisoning and certain other consequences of external causesS00-T88 — Injury, poisoning and certain other consequences of external causes
DefinitionUnspecified fracture of upper end of right humerus is a non-billable ICD-10-CM category code (S42.201).Unspecified fracture of upper end of left humerus is a non-billable ICD-10-CM category code (S42.202).
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