S42.92XG vs S48

S42.92XG (Fracture of left shoulder girdle, part unspecified, subsequent encounter for fracture with delayed healing) compared with S48 (Traumatic amputation of shoulder and upper arm), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1. MedCoder-derived

Relationship

Conflict

Excludes1 conflict

S42.92XG

Fracture of left shoulder girdle, part unspecified, subsequent encounter for fracture with delayed healing

↔

S48

Traumatic amputation of shoulder and upper arm

Not coded here — these two are mutually exclusive.

“traumatic amputation of shoulder and upper arm (S48.-)”

An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as unrelated to each other.

Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Can these codes be reported together?

No — do not report together. S42.92XG carries an Excludes1 note covering S48: “traumatic amputation of shoulder and upper arm (S48.-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

	S42.92XGFracture of left shoulder girdle, part unspecified, subsequent encounter for fracture with delayed healing	S48Traumatic amputation of shoulder and upper arm
Billing status	Billable	Non-billable header Report instead: S48.011A, S48.011D, S48.011S, S48.012A, S48.012D
Classification	S00-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)
Definition	Fracture of left shoulder girdle, part unspecified, subsequent encounter for fracture with delayed healing is a billable ICD-10-CM diagnosis code (S42.92XG).	Traumatic amputation of shoulder and upper arm is a non-billable ICD-10-CM category code (S48).
7th character	The appropriate 7th character is to be added to all codes from category S42	The appropriate 7th character is to be added to each code from category S48
Includes	injuries of axilla injuries of scapular region	injuries of axilla injuries of scapular region An amputation not identified as partial or complete should be coded to complete

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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