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S42.402S vs S42.409S

S42.402S (Unspecified fracture of lower end of left humerus, sequela) compared with S42.409S (Unspecified fracture of lower end of unspecified humerus, sequela), from the official CMS tabular data. S42.402S and S42.409S code the same condition on opposite sides.

Relationship

Review

Laterality relationship

S42.402S
Left
Unspecified fracture of lower end of left humerus, sequela
S42.409S
Unspecified
Unspecified fracture of lower end of unspecified humerus, sequela

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. S42.402S and S42.409S 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

S42.402SUnspecified fracture of lower end of left humerus, sequelaS42.409SUnspecified fracture of lower end of unspecified humerus, sequela
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 left humerus, sequela is a billable ICD-10-CM diagnosis code (S42.402S).Unspecified fracture of lower end of unspecified humerus, sequela is a billable ICD-10-CM diagnosis code (S42.409S).
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

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