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S49.092A vs S49.099A

S49.092A (Other physeal fracture of upper end of humerus, left arm, initial encounter for closed fracture) compared with S49.099A (Other physeal fracture of upper end of humerus, unspecified arm, initial encounter for closed fracture), from the official CMS tabular data. S49.092A and S49.099A code the same condition on opposite sides.

Relationship

Review

Laterality relationship

S49.092A
Left
Other physeal fracture of upper end of humerus, left arm, initial encounter for closed fracture
↔
S49.099A
Unspecified
Other physeal fracture of upper end of humerus, unspecified arm, initial encounter for closed fracture

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. S49.092A and S49.099A 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

S49.092AOther physeal fracture of upper end of humerus, left arm, initial encounter for closed fractureS49.099AOther physeal fracture of upper end of humerus, unspecified arm, initial encounter for closed fracture
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)
DefinitionOther physeal fracture of upper end of humerus, left arm, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S49.092A).Other physeal fracture of upper end of humerus, unspecified arm, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S49.099A).
7th characterThe appropriate 7th character is to be added to each code from subcategories S49.0 and S49.1The appropriate 7th character is to be added to each code from subcategories S49.0 and S49.1
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