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S42.473A vs S42.473S

S42.473A (Displaced transcondylar fracture of unspecified humerus, initial encounter for closed fracture) compared with S42.473S (Displaced transcondylar fracture of unspecified humerus, sequela), from the official CMS tabular data. S42.473A and S42.473S code the same injury at a different phase of treatment.

Relationship

Review

Encounter relationship

S42.473A
Initial encounter
Displaced transcondylar fracture of unspecified humerus, initial encounter for closed fracture
S42.473S
Sequela
Displaced transcondylar fracture of unspecified humerus, sequela

Same underlying diagnosis, different encounter phase.

The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.

Source: ICD-10-CM Official Guidelines, Section I.C.19.a

Can these codes be reported together?

Same injury, other encounter phase. S42.473A and S42.473S code the same injury at a different phase of treatment, set by the 7th character.

The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.

Side by side

S42.473ADisplaced transcondylar fracture of unspecified humerus, initial encounter for closed fractureS42.473SDisplaced transcondylar fracture 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)
DefinitionDisplaced transcondylar fracture of unspecified humerus, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S42.473A).Displaced transcondylar fracture of unspecified humerus, sequela is a billable ICD-10-CM diagnosis code (S42.473S).
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