S42.211B vs S42.212B

S42.211B (Unspecified displaced fracture of surgical neck of right humerus, initial encounter for open fracture) compared with S42.212B (Unspecified displaced fracture of surgical neck of left humerus, initial encounter for open fracture), from the official CMS tabular data. S42.211B and S42.212B code the same condition on opposite sides. MedCoder-derived

Relationship

Review

Laterality relationship

S42.211B

Right

Unspecified displaced fracture of surgical neck of right humerus, initial encounter for open fracture

↔

S42.212B

Left

Unspecified displaced fracture of surgical neck of left humerus, initial encounter for open fracture

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. S42.211B and S42.212B 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

	S42.211BUnspecified displaced fracture of surgical neck of right humerus, initial encounter for open fracture	S42.212BUnspecified displaced fracture of surgical neck of left humerus, initial encounter for open fracture
Billing status	Billable	Billable
Classification	S00-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)
Definition	Unspecified displaced fracture of surgical neck of right humerus, initial encounter for open fracture is a billable ICD-10-CM diagnosis code (S42.211B).	Unspecified displaced fracture of surgical neck of left humerus, initial encounter for open fracture is a billable ICD-10-CM diagnosis code (S42.212B).
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