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S42.264D vs S42.266D

S42.264D (Nondisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with routine healing) compared with S42.266D (Nondisplaced fracture of lesser tuberosity of unspecified humerus, subsequent encounter for fracture with routine healing), from the official CMS tabular data. S42.264D and S42.266D code the same condition on opposite sides. MedCoder-derived

Relationship

Review

Laterality relationship

S42.264D
Right
Nondisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with routine healing
↔
S42.266D
Unspecified
Nondisplaced fracture of lesser tuberosity of unspecified humerus, subsequent encounter for fracture with routine healing

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. S42.264D and S42.266D 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

S42.264DNondisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with routine healingS42.266DNondisplaced fracture of lesser tuberosity of unspecified humerus, subsequent encounter for fracture with routine healing
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)
DefinitionNondisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with routine healing is a billable ICD-10-CM diagnosis code (S42.264D).Nondisplaced fracture of lesser tuberosity of unspecified humerus, subsequent encounter for fracture with routine healing is a billable ICD-10-CM diagnosis code (S42.266D).
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