ICD Code S42.201A

ICD code S42.201A is used to classify an unspecified fracture of the upper end of the right humerus, specifically for the initial encounter when the fracture is closed. This code is part of the ICD-10-CM system, which is used by healthcare providers to document diagnoses and conditions for billing and statistical purposes. The "S" indicates an injury, the "42" specifies the humerus, "201" denotes an unspecified fracture of the upper end, and "A" signifies that this is the initial encounter for treatment of a closed fracture.

1. Patient presents with pain in the right shoulder or upper arm area following a recent injury or trauma.

2. Physical examination reveals swelling, bruising, or tenderness localized to the upper end of the right humerus.

3. Limited range of motion or inability to move the right shoulder or arm without significant discomfort.

4. Radiographic imaging, such as X-rays, confirms the presence of a fracture at the upper end of the right humerus.

5. The fracture is identified as closed, meaning the skin over the fracture site is intact.

6. The encounter is the initial visit for this specific injury, indicating that the patient has not previously been treated for this fracture.

7. No specific fracture type (e.g., transverse, oblique, comminuted) is identified, necessitating the use of an unspecified code.

For the ICD code S42.201A, the relevant CPT codes that may be applicable for treatment include:

1. 23600 - Closed treatment of proximal humeral (surgical or anatomical neck) fracture; without manipulation.

2. 23605 - Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation.

3. 23615 - Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed.

4. 23616 - Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation or prosthetic replacement.

5. 24500 - Closed treatment of humeral shaft fracture; without manipulation.

6. 24505 - Closed treatment of humeral shaft fracture; with manipulation, with or without skin or skeletal traction.

7. 24515 - Open treatment of humeral shaft fracture, includes internal fixation, when performed.

These CPT codes are typically used to describe the procedures that may be performed to treat the condition associated with ICD code S42.201A. It is important for healthcare providers to select the appropriate CPT code based on the specific treatment rendered.

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