What You Need to Know
You would code the aftercare codes for follow up visits while the fracture is healing after the initial treatment. The guidelines state: "Fractures are coded using the aftercare codes for encounters after the patient has completed active treatment of the fracture and is receiving routine care for the fracture during the healing or recovery phase.
S42. 291A - Other displaced fracture of upper end of right humerus [initial encounter for closed fracture]. ICD-10-CM.
ICD-10 Code for Other fracture of upper end of humerus- S42. 29- Codify by AAPC.
The proximal humerus is composed of four distinct anatomic segments: 1) the shaft of the humerus, 2) the greater tuberosity, 3) the lesser tuberosity, and 4) the articular or head segment. These segments correspond to the four ossification centers of the proximal humerus.
Patients with operatively treated proximal humeral fractures were identified via a computerized search of our institution's billing database utilizing the CPT code 23615 (open treatment of proximal humeral fracture).
Unspecified fracture of shaft of humerus, unspecified arm, initial encounter for closed fracture. S42. 309A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM S42.
A humerus fracture is the medical name for breaking the bone in your upper arm (your humerus). Humerus fractures are usually caused by traumas like car accidents or falls. If you break your humerus, you might need surgery to repair your bone.
The top of the humerus forms part of the shoulder joint with its connection to the scapula (shoulder blade), and the bottom of the humerus forms part of the elbow with the forearm. The middle of the humerus is called the humeral shaft and fracture of this part of the bone is called a humeral shaft fracture.
The humerus is a long bone located in the upper arm, between the shoulder joint and elbow joint. The proximal humerus connects to the shoulder through the glenoid fossa of the scapula, forming the glenohumeral joint. The distal humerus articulates at the elbow to the radius and ulna in the forearm.
A proximal humerus fracture usually occurs close to the shoulder joint and can be located at different levels with different fracture patterns: simple or comminuted. A humerus shaft fracture, on the other hand, is one that is localized at the mid portion of the upper arm.
The database was searched for records from 2004 to 2013 for humeral shaft surgical cases as indicated by Current Procedural Terminology (CPT) codes 24515 (open reduction internal fixation) and 24516 (insertion of intramedullary nail) pertaining to humeral shaft fractures.
Http://www.cms.hhs.gov/MedHCPCSGeninfo/. The AMA defines CPT code 23472 as “arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder)).” Current Procedural Terminology (CPT), Professional Edition (American Medical Association 2010).
CPT® 23615 in section: Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed.
There are three main surgical techniques to treat humeral shaft fractures: open reduction and plate fixation (ORPF), intramedullary nail (IMN) fixation, and minimally invasive percutaneous osteosynthesis (MIPO).
The radial nerve is most likely to be damaged in humerus fractures that have a lateral displacement of the distal fracture segment, as the nerve is tethered to the bone and cannot withstand the forces applied to it as a result of the displacement.
Approximately 90% of well-selected humeral shaft fractures will heal without surgery. It takes approximately 12 weeks for bony healing in most cases. Some fractures will benefit from early fixation.
The two complications often seen are injuries to the radial nerve and nonunion of the fracture.
Physeal fractures of upper end of humerus - instead, use code S49.0-. Physeal fractures of lower end of humerus - instead, use code S49.1-. Parent Code: S42 - Fracture of shoulder and upper arm.
Use a child code to capture more detail. ICD Code S42.3 is a non-billable code.