ICD Code S42.201A

ICD code S42.201A is an unspecified fracture of the upper end of the right humerus, for a patient’s initial visit where the bone has not broken through the skin (closed fracture).

1. Patient presents with a fracture located at the upper end of the right humerus

2. The specific type or pattern of the fracture is not identified or documented

3. The fracture is confirmed to be closed, with no associated open wound

4. This is the patient’s initial encounter for active treatment of the injury

5. Clinical evaluation and imaging confirm the diagnosis but do not further specify the fracture type

Relevant CPT codes that may be used to treat ICD code S42.201A include:

- 23600: Closed treatment of proximal humeral (surgical or anatomical neck) fracture; without manipulation

- 23605: Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation

- 23615: Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed

- 23630: Open treatment of greater humeral tuberosity fracture, includes internal fixation, when performed

- 23670: Closed treatment of humeral shaft fracture; without manipulation

- 23675: Closed treatment of humeral shaft fracture; with manipulation

- 9920X–9921X: Evaluation and management (E/M) codes for office or other outpatient visits, as appropriate

CPT code selection should be based on the specific clinical scenario and treatment rendered for S42.201A.

Schedule a demo to see how MD Clarity’s RevFind software can automatically read your contracts and detect underpayments for CPT codes related to ICD code S42.201A. Ensure your organization is paid accurately—discover how RevFind can help you identify and recover missed revenue.