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S42.202P vs S42.209P

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

Relationship

Review

Laterality relationship

S42.202P
Left
Unspecified fracture of upper end of left humerus, subsequent encounter for fracture with malunion
↔
S42.209P
Unspecified
Unspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with malunion

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. S42.202P and S42.209P 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

S42.202PUnspecified fracture of upper end of left humerus, subsequent encounter for fracture with malunionS42.209PUnspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with malunion
Billing statusBillableBillable
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, subsequent encounter for fracture with malunion is a billable ICD-10-CM diagnosis code (S42.202P).Unspecified fracture of upper end of unspecified humerus, subsequent encounter for fracture with malunion is a billable ICD-10-CM diagnosis code (S42.209P).
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
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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