S42.292A vs S42.292K

S42.292A (Other displaced fracture of upper end of left humerus, initial encounter for closed fracture) compared with S42.292K (Other displaced fracture of upper end of left humerus, subsequent encounter for fracture with nonunion), from the official CMS tabular data.

Summary

These codes describe the same injury at different phases of treatment, so the 7th character that matches the encounter decides which one applies.

MedCoder-derived

What is different?

Title wording.The titles share “Other displaced fracture of upper end of left humerus”; S42.292A says “initial encounter for closed fracture” where S42.292K says “subsequent encounter for fracture with nonunion”.

Registry fact

Can these codes be reported together?

One per encounter.S42.292A and S42.292K code the same injury at a different phase of treatment, set by the 7th character. The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.

MedCoder-derivedGuide: 7th characters: initial, subsequent, sequela

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. S42.292A carries 1 Excludes1 note and S42.292K carries 1 Excludes1 note covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code. S42.292A carries 7 Excludes2 notes and S42.292K carries 7 Excludes2 notes covering other codes; the side-by-side table quotes them.

Official rule

Is one more specific?

No.Neither is a subdivision of the other, and neither title is the unspecified form; they describe different conditions within category S42.

Registry fact

Is one a parent or header code?

No.Both are billable codes, and neither contains the other.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

Yes.Same injury, other encounter phase. S42.292A and S42.292K code the same injury at a different phase of treatment, set by the 7th character.

MedCoder-derivedGuide: 7th characters: initial, subsequent, sequela

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule.

Can these codes be reported together?

Review

Encounter relationship

S42.292A

Initial encounter

Other displaced fracture of upper end of left humerus, initial encounter for closed fracture

↔

S42.292K

Subsequent encounter

Other displaced fracture of upper end of left humerus, subsequent encounter for fracture with nonunion

What we found

Same injury, other encounter phase.S42.292A and S42.292K code the same injury at a different phase of treatment, set by the 7th character.

The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.

What to review

Use the 7th character that matches the encounter being coded (initial, subsequent or sequela); one encounter takes one of them.

Guide: 7th characters: initial, subsequent, sequela Check these on a claim

Why it matters

The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.

Source / rule

ICD-10-CM Official Guidelines, Section I.C.19.a

Side by side

	S42.292AOther displaced fracture of upper end of left humerus, initial encounter for closed fracture	S42.292KOther displaced fracture of upper end of left humerus, subsequent encounter for fracture with nonunion
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	Other displaced fracture of upper end of left humerus, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S42.292A).	Other displaced fracture of upper end of left humerus, subsequent encounter for fracture with nonunion is a billable ICD-10-CM diagnosis code (S42.292K).
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
Excludes1	traumatic amputation of shoulder and upper arm (S48.-)	traumatic amputation of shoulder and upper arm (S48.-)
Excludes2	fracture of shaft of humerus (S42.3-) physeal fracture of upper end of humerus (S49.0-) periprosthetic fracture around internal prosthetic shoulder joint (M97.3) burns and corrosions (T20-T32) frostbite (T33-T34) injuries of elbow (S50-S59) insect bite or sting, venomous (T63.4)	fracture of shaft of humerus (S42.3-) physeal fracture of upper end of humerus (S49.0-) periprosthetic fracture around internal prosthetic shoulder joint (M97.3) burns and corrosions (T20-T32) frostbite (T33-T34) injuries of elbow (S50-S59) insect bite or sting, venomous (T63.4)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2026). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources