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S42.401K vs S42.409K

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

Relationship

Review

Laterality relationship

S42.401K
Right
Unspecified fracture of lower end of right humerus, subsequent encounter for fracture with nonunion
↔
S42.409K
Unspecified
Unspecified fracture of lower end of unspecified humerus, subsequent encounter for fracture with nonunion

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. S42.401K and S42.409K 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

S42.401KUnspecified fracture of lower end of right humerus, subsequent encounter for fracture with nonunionS42.409KUnspecified fracture of lower end of unspecified humerus, subsequent encounter for fracture with nonunion
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)
DefinitionUnspecified fracture of lower end of right humerus, subsequent encounter for fracture with nonunion is a billable ICD-10-CM diagnosis code (S42.401K).Unspecified fracture of lower end of unspecified humerus, subsequent encounter for fracture with nonunion is a billable ICD-10-CM diagnosis code (S42.409K).
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