ICD 10 CM S42.295B | Description & Clinical Information

ICD 10 S42.295B describes a specific type of fracture that occurs in the upper end of the left humerus, which is the long bone located between the shoulder and elbow, resulting from sudden or blunt trauma, motor vehicle accidents, sports activities, or falls on an outstretched arm, where the fractured segments remain aligned in their original position, and is identified by the provider as a fracture type that is not represented by another code in this category for the initial encounter for open fracture in which the cracked bones penetrate the skin.

Official Description Of S42.295B

The ICD 10 CM book defines ICD 10 code S42.295B as:

Other nondisplaced fracture of upper end of left humerus, initial encounter for open fracture
Parent Code Notes: S42.2

Excludes2: fracture of shaft of humerus (S42.3-)
physeal fracture of upper end of humerus (S49.0-)

Parent Code Notes: S42

Excludes1: traumatic amputation of shoulder and upper arm (S48.-)

When To Use S42.295B

The diagnosis describes by the ICD-10-CM S42.295B code is categorized as “Other nondisplaced fracture of upper end of the left humerus.” This diagnosis is usually caused by trauma, such as a fall, sports injury, or workplace accident, and can result in significant pain, swelling, bruising, and deformity of the affected area.

When a patient visits a healthcare provider with a possible upper arm fracture, the provider will evaluate the patient’s symptoms and medical history. They will typically perform a physical examination, focusing on the affected area, to assess the severity of the injury, look for signs of nerve damage or infection, and assess the blood supply to the affected area. The healthcare provider may also order imaging tests such as X-rays, CT scans, or MRIs to determine the extent of the damage and establish a treatment plan.

In most cases, treatment for a nondisplaced fracture of the upper end of the left humerus involves medication management. Providers may prescribe analgesics, corticosteroids, muscle relaxants, nonsteroidal anti-inflammatory drugs, and thrombolytics or anticoagulants to reduce the risk of blood clots. In addition to medication, patients may be advised to take calcium and vitamin D supplements to help improve bone strength.

Immobilization of the affected arm is crucial to preventing further damage and promoting healing. A splint or soft cast may be applied to the affected area, and the patient may be advised to limit physical activity and rest as much as possible. Regular icing, compression, and elevation of the affected area may also be recommended to reduce swelling and assist in pain management.

Physical therapy is often used to improve the range of motion, flexibility, and muscle strength in the affected arm. Closed reduction or surgical open reduction and internal fixation may be necessary depending on the severity of the fracture.

It is important for medical coders to be familiar with the ICD-10-CM code for this diagnosis, as it will help facilitate proper billing and ensure accurate medical records. When coding for this diagnosis, it is essential to follow the specific guidelines set forth by the ICD-10-CM to ensure accurate classification of the fracture.

In conclusion, a nondisplaced fracture of the upper end of the left humerus can result in significant pain and immobilization. Early diagnosis and treatment are key to a successful recovery. Healthcare providers will typically administer medication, encourage immobilization, and may prescribe physical therapy to help the patient regain strength and flexibility in the affected area. Medical coders must be proficient in assigning the correct ICD-10-CM code for this diagnosis to accurately reflect the services provided and ensure proper billing for the patient.

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