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Compare/S42.40 vs S52.0

S42.40 vs S52.0

S42.40 (Unspecified fracture of lower end of humerus) compared with S52.0 (Fracture of upper end of ulna), 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. S52.0 carries an Excludes2 note covering S42.40: “fracture of elbow NOS (S42.40-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

S42.40Unspecified fracture of lower end of humerusS52.0Fracture of upper end of ulna
Billing statusNon-billable header

Report instead: S42.401A, S42.401B, S42.401D, S42.401G, S42.401K

Non-billable header

Report instead: S52.001A, S52.001B, S52.001C, S52.001D, S52.001E

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)
DefinitionUnspecified fracture of lower end of humerus is a non-billable ICD-10-CM category code (S42.40).Fracture of upper end of ulna is a non-billable ICD-10-CM category code (S52.0).
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 S52
Includes
injuries of axilla
injuries of scapular region
Fracture of elbow NOS
Fracture of proximal end of ulna

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources