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S42.454 vs S42.455

S42.454 (Nondisplaced fracture of lateral condyle of right humerus) compared with S42.455 (Nondisplaced fracture of lateral condyle of left humerus), from the official CMS tabular data. S42.454 and S42.455 code the same condition on opposite sides. MedCoder-derived

Relationship

Review

Laterality relationship

S42.454
Right
Nondisplaced fracture of lateral condyle of right humerus
S42.455
Left
Nondisplaced fracture of lateral condyle of left 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. S42.454 and S42.455 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

S42.454Nondisplaced fracture of lateral condyle of right humerusS42.455Nondisplaced fracture of lateral condyle of left humerus
Billing statusNon-billable header

Report instead: S42.454A, S42.454B, S42.454D, S42.454G, S42.454K

Non-billable header

Report instead: S42.455A, S42.455B, S42.455D, S42.455G, S42.455K

ClassificationS00-T88 — Injury, poisoning and certain other consequences of external causesS00-T88 — Injury, poisoning and certain other consequences of external causes
DefinitionNondisplaced fracture of lateral condyle of right humerus is a non-billable ICD-10-CM category code (S42.454).Nondisplaced fracture of lateral condyle of left humerus is a non-billable ICD-10-CM category code (S42.455).
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