S42.255P vs S42.256P

S42.255P (Nondisplaced fracture of greater tuberosity of left humerus, subsequent encounter for fracture with malunion) compared with S42.256P (Nondisplaced fracture of greater tuberosity of unspecified humerus, subsequent encounter for fracture with malunion), from the official CMS tabular data. S42.255P and S42.256P code the same condition on opposite sides. MedCoder-derived

Relationship

Review

Laterality relationship

S42.255P

Left

Nondisplaced fracture of greater tuberosity of left humerus, subsequent encounter for fracture with malunion

↔

S42.256P

Unspecified

Nondisplaced fracture of greater tuberosity 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. S42.255P and S42.256P 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

	S42.255PNondisplaced fracture of greater tuberosity of left humerus, subsequent encounter for fracture with malunion	S42.256PNondisplaced fracture of greater tuberosity of unspecified humerus, subsequent encounter for fracture with malunion
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	Nondisplaced fracture of greater tuberosity of left humerus, subsequent encounter for fracture with malunion is a billable ICD-10-CM diagnosis code (S42.255P).	Nondisplaced fracture of greater tuberosity of unspecified humerus, subsequent encounter for fracture with malunion is a billable ICD-10-CM diagnosis code (S42.256P).
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