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S42.401G vs S42.409G

S42.401G (Unspecified fracture of lower end of right humerus, subsequent encounter for fracture with delayed healing) compared with S42.409G (Unspecified fracture of lower end of unspecified humerus, subsequent encounter for fracture with delayed healing), from the official CMS tabular data. S42.401G and S42.409G code the same condition on opposite sides. MedCoder-derived

Relationship

Review

Laterality relationship

S42.401G
Right
Unspecified fracture of lower end of right humerus, subsequent encounter for fracture with delayed healing
↔
S42.409G
Unspecified
Unspecified fracture of lower end of unspecified humerus, subsequent encounter for fracture with delayed 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. S42.401G and S42.409G 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

S42.401GUnspecified fracture of lower end of right humerus, subsequent encounter for fracture with delayed healingS42.409GUnspecified fracture of lower end of unspecified humerus, subsequent encounter for fracture with delayed healing
Billing statusBillableBillable
ClassificationS00-T88 — Injury, poisoning and certain other consequences of external causesS00-T88 — Injury, poisoning and certain other consequences of external causes
DefinitionUnspecified fracture of lower end of right humerus, subsequent encounter for fracture with delayed healing is a billable ICD-10-CM diagnosis code (S42.401G).Unspecified fracture of lower end of unspecified humerus, subsequent encounter for fracture with delayed healing is a billable ICD-10-CM diagnosis code (S42.409G).
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