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S42.202 vs S42.209

S42.202 (Unspecified fracture of upper end of left humerus) compared with S42.209 (Unspecified fracture of upper end of unspecified humerus), from the official CMS tabular data. S42.202 and S42.209 code the same condition on opposite sides.

Relationship

Review

Laterality relationship

S42.202
Left
Unspecified fracture of upper end of left humerus
S42.209
Unspecified
Unspecified fracture of upper end of unspecified 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. S42.202 and S42.209 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

S42.202Unspecified fracture of upper end of left humerusS42.209Unspecified fracture of upper end of unspecified humerus
Billing statusNon-billable header

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

Non-billable header

Report instead: S42.209A, S42.209B, S42.209D, S42.209G, S42.209K

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)
DefinitionUnspecified fracture of upper end of left humerus is a non-billable ICD-10-CM category code (S42.202).Unspecified fracture of upper end of unspecified humerus is a non-billable ICD-10-CM category code (S42.209).
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