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S42.415 vs S42.416

S42.415 (Nondisplaced simple supracondylar fracture without intercondylar fracture of left humerus) compared with S42.416 (Nondisplaced simple supracondylar fracture without intercondylar fracture of unspecified humerus), from the official CMS tabular data. S42.415 and S42.416 code the same condition on opposite sides. MedCoder-derived

Relationship

Review

Laterality relationship

S42.415
Left
Nondisplaced simple supracondylar fracture without intercondylar fracture of left humerus
↔
S42.416
Unspecified
Nondisplaced simple supracondylar fracture without intercondylar fracture of unspecified humerus

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. S42.415 and S42.416 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

S42.415Nondisplaced simple supracondylar fracture without intercondylar fracture of left humerusS42.416Nondisplaced simple supracondylar fracture without intercondylar fracture of unspecified humerus
Billing statusNon-billable header

Report instead: S42.415A, S42.415B, S42.415D, S42.415G, S42.415K

Non-billable header

Report instead: S42.416A, S42.416B, S42.416D, S42.416G, S42.416K

ClassificationS00-T88 — Injury, poisoning and certain other consequences of external causesS00-T88 — Injury, poisoning and certain other consequences of external causes
DefinitionNondisplaced simple supracondylar fracture without intercondylar fracture of left humerus is a non-billable ICD-10-CM category code (S42.415).Nondisplaced simple supracondylar fracture without intercondylar fracture of unspecified humerus is a non-billable ICD-10-CM category code (S42.416).
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