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S42.301A
ICD-10-CM
Fracture of Right Humerus

Find information on Fracture of Right Humerus diagnosis, including clinical documentation, medical coding, and healthcare resources. Learn about Right Humerus Break and Right Arm Fracture, covering symptoms, treatment, and ICD-10 coding guidelines for accurate medical recordkeeping. This resource supports healthcare professionals in proper diagnosis and documentation of humerus fractures.

Also known as

Right Humerus Break
Right Arm Fracture

Diagnosis Snapshot

Key Facts
  • Definition : Break in the bone of the upper right arm.
  • Clinical Signs : Pain, swelling, bruising, deformity, limited arm movement.
  • Common Settings : Falls, sports injuries, direct blows to the arm.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC S42.301A Coding
S42.2

Fracture of upper end of right humerus

Includes fractures of anatomical neck, surgical neck, greater/lesser tuberosity.

S42.3

Fracture of shaft of right humerus

Fracture of the diaphysis or middle part of the right humerus bone.

S42.4

Fracture of lower end of right humerus

Includes fractures of the distal end, condyles, and epicondyles.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the fracture traumatic?

  • Yes

    Open or closed fracture?

  • No

    Pathological fracture?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Fracture of right upper arm bone.
Fracture of left upper arm bone.
Generalized arm pain, right side.

Documentation Best Practices

Documentation Checklist
  • Humerus fracture type (e.g., transverse, spiral)
  • Right humerus fracture location (e.g., distal, midshaft)
  • Mechanism of injury documented
  • Neurovascular status of right arm assessed and documented
  • Associated injuries (if any) documented

Coding and Audit Risks

Common Risks
  • Specificity of Fracture

    Coding requires specifying the fracture type (e.g., displaced, comminuted) for accurate reimbursement and clinical documentation.

  • Laterality Documentation

    Missing or incorrect laterality (right vs. left) can lead to coding errors and claim denials. Clear documentation is crucial.

  • Unspecified vs. Closed/Open

    Failing to distinguish between unspecified, closed, or open fractures affects coding accuracy and subsequent treatment protocols.

Mitigation Tips

Best Practices
  • Accurate ICD-10 coding for humerus fracture type (e.g., S42.201A)
  • Detailed documentation of fracture location, displacement, and cause
  • Timely orthopedic consult for optimal fracture management
  • Pain management documentation supporting medical necessity
  • Patient education documented on fall prevention and bone health

Clinical Decision Support

Checklist
  • Confirm right humerus fracture via imaging (X-ray/CT).
  • Document fracture type, location, and displacement.
  • Assess neurovascular status of right arm/hand.
  • Evaluate for associated injuries (shoulder/elbow).
  • Consider pain management and orthopedics consult.

Reimbursement and Quality Metrics

Impact Summary
  • Impact: Accurate ICD-10 coding (e.g., S42.201A) maximizes right humerus fracture reimbursement.
  • Impact: Proper documentation of fracture type and location impacts quality metrics for orthopedic trauma.
  • Impact: Coding compliance and specificity reduce claim denials and improve hospital revenue cycle.
  • Impact: Precise coding supports performance benchmarking and quality improvement initiatives for fractures.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Frequently Asked Questions

Common Questions and Answers

Q: What are the key clinical indicators differentiating a proximal humerus fracture from a humeral shaft fracture in a patient presenting with right arm pain and limited range of motion?

A: Differentiating between a proximal humerus fracture and a humeral shaft fracture relies on careful clinical examination and imaging. Proximal humerus fractures typically present with pain and tenderness localized to the shoulder area, with limited abduction and external rotation. Humeral shaft fractures, on the other hand, present with pain and tenderness along the mid-portion of the arm, often with obvious deformity or crepitus. Neurovascular assessment is crucial in both cases, as radial nerve palsy is more common in humeral shaft fractures. Plain radiographs are essential for initial evaluation, but CT scans may be necessary for complex fractures or surgical planning. Explore how advanced imaging modalities can enhance the evaluation and management of humerus fractures.

Q: When is conservative management appropriate for a right humerus fracture, and what best practice rehabilitation protocols should be considered for optimal functional recovery?

A: Conservative management, involving immobilization and pain control, is often suitable for non-displaced or minimally displaced right humerus fractures. Factors like fracture pattern, patient age, and functional demands influence this decision. Early mobilization is paramount to prevent stiffness and optimize functional recovery. Rehabilitation protocols should be tailored to the individual patient and may involve a progression from passive range of motion exercises to active assisted and strengthening exercises as pain allows. Consider implementing a phased rehabilitation program with clear goals and evidence-based modalities. Learn more about the latest research supporting early functional rehabilitation in humerus fractures.

Quick Tips

Practical Coding Tips
  • Code right humerus fracture S42.2
  • Verify laterality documentation
  • Check for displacement type
  • Consider associated injuries
  • Document fracture specifics

Documentation Templates

Patient presents with complaints of right arm pain and limited range of motion following a fall.  Physical examination reveals localized tenderness, swelling, and ecchymosis over the right humerus.  Crepitus is palpable at the fracture site.  Neurovascular assessment of the right hand and fingers shows intact sensation and capillary refill.  Radiographic imaging of the right humerus confirms a closed, displaced fracture of the humeral shaft.  Diagnosis:  Closed fracture of the right humerus.  Differential diagnoses considered included humeral contusion, shoulder dislocation, and rotator cuff tear.  Treatment plan includes closed reduction and immobilization with a brace.  Patient education provided regarding pain management, activity modification, and follow-up care.  ICD-10 code S42.201A will be used for right humerus fracture, closed, unspecified part.  CPT codes for closed reduction of the humeral shaft fracture will be determined based on the specific procedure performed.  The patient will be scheduled for follow-up with orthopedics for repeat radiographs and further evaluation.  Prognosis is good with appropriate treatment and adherence to the recommended rehabilitation plan.  Potential complications discussed with the patient include malunion, nonunion, infection, and radial nerve palsy.
Fracture of Right Humerus - AI-Powered ICD-10 Documentation