S42.3 vs S42.40
S42.3 (Fracture of shaft of humerus) compared with S42.40 (Unspecified fracture of lower end of humerus), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. S42.40 carries an Excludes2 note covering S42.3: “fracture of shaft of humerus (S42.3-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| S42.3Fracture of shaft of humerus | S42.40Unspecified fracture of lower end of humerus | |
|---|---|---|
| Billing status | Non-billable header Report instead: S42.301A, S42.301B, S42.301D, S42.301G, S42.301K | Non-billable header Report instead: S42.401A, S42.401B, S42.401D, S42.401G, S42.401K |
| 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 | Fracture of shaft of humerus is a non-billable ICD-10-CM category code (S42.3). | Unspecified fracture of lower end of humerus is a non-billable ICD-10-CM category code (S42.40). |
| 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 Fracture of humerus NOS Fracture of upper arm NOS | injuries of axilla injuries of scapular region Fracture of elbow NOS |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources