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S42.90XD vs S42.91XD

S42.90XD (Fracture of unspecified shoulder girdle, part unspecified, subsequent encounter for fracture with routine healing) compared with S42.91XD (Fracture of right shoulder girdle, part unspecified, subsequent encounter for fracture with routine healing), from the official CMS tabular data. S42.90XD and S42.91XD code the same condition on opposite sides. MedCoder-derived

Relationship

Review

Laterality relationship

S42.90XD
Unspecified
Fracture of unspecified shoulder girdle, part unspecified, subsequent encounter for fracture with routine healing
↔
S42.91XD
Right
Fracture of right shoulder girdle, part unspecified, subsequent encounter for fracture with routine healing

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. S42.90XD and S42.91XD 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

S42.90XDFracture of unspecified shoulder girdle, part unspecified, subsequent encounter for fracture with routine healingS42.91XDFracture of right shoulder girdle, part unspecified, subsequent encounter for fracture with routine healing
Billing statusBillableBillable
ClassificationS00-T88 — Injury, poisoning and certain other consequences of external causesS00-T88 — Injury, poisoning and certain other consequences of external causes
DefinitionFracture of unspecified shoulder girdle, part unspecified, subsequent encounter for fracture with routine healing is a billable ICD-10-CM diagnosis code (S42.90D).Fracture of right shoulder girdle, part unspecified, subsequent encounter for fracture with routine healing is a billable ICD-10-CM diagnosis code (S42.91D).
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