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S42.474 vs S42.476

S42.474 (Nondisplaced transcondylar fracture of right humerus) compared with S42.476 (Nondisplaced transcondylar fracture of unspecified humerus), from the official CMS tabular data. S42.474 and S42.476 code the same condition on opposite sides. MedCoder-derived

Relationship

Review

Laterality relationship

S42.474
Right
Nondisplaced transcondylar fracture of right humerus
S42.476
Unspecified
Nondisplaced transcondylar 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. S42.474 and S42.476 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

S42.474Nondisplaced transcondylar fracture of right humerusS42.476Nondisplaced transcondylar fracture of unspecified humerus
Billing statusNon-billable header

Report instead: S42.474A, S42.474B, S42.474D, S42.474G, S42.474K

Non-billable header

Report instead: S42.476A, S42.476B, S42.476D, S42.476G, S42.476K

ClassificationS00-T88 — Injury, poisoning and certain other consequences of external causesS00-T88 — Injury, poisoning and certain other consequences of external causes
DefinitionNondisplaced transcondylar fracture of right humerus is a non-billable ICD-10-CM category code (S42.474).Nondisplaced transcondylar fracture of unspecified humerus is a non-billable ICD-10-CM category code (S42.476).
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