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ICD-10 Coding for Fracture of Right Clavicle(S42.021A, S42.021D)

Complete ICD-10-CM coding and documentation guide for Fracture of Right Clavicle. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Right Clavicle BreakRight Collarbone Fracture

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Related ICD-10 Code Ranges

Complete code families applicable to Fracture of Right Clavicle

S42.01-S42.09Primary Range

Fracture of clavicle

This range includes all specific codes for fractures of the clavicle, including the right clavicle.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
S42.021ADisplaced fracture of shaft of right clavicle, initial encounter for closed fractureUse when imaging confirms a displaced fracture of the shaft of the right clavicle during the initial encounter.
  • X-ray showing displacement
  • Clinical documentation of deformity or tenting skin
S42.021DDisplaced fracture of shaft of right clavicle, subsequent encounter for fracture with routine healingUse for follow-up visits when the fracture is healing as expected.
  • Follow-up X-ray showing healing progress

Clinical Decision Support

Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.

Key Information: ICD-10 code for displaced right clavicle fracture

Essential facts and insights about Fracture of Right Clavicle

The ICD-10 code for a displaced fracture of the shaft of the right clavicle, initial encounter, is S42.021A.

Primary ICD-10-CM Codes for fracture right clavicle

S42.021A
Displaced fracture of shaft of right clavicle, initial encounter for closed fracture
Billable Code

Decision Criteria

clinical Criteria

  • X-ray confirms displacement

documentation Criteria

  • Documentation specifies 'displaced' and 'shaft'

Applicable To

  • Displaced fracture of midshaft of right clavicle

Excludes

  • Fracture of unspecified part of clavicle (S42.001A)

Clinical Validation Requirements

  • X-ray showing displacement
  • Clinical documentation of deformity or tenting skin

Code-Specific Risks

  • Misclassification if laterality or displacement is not documented

Coding Notes

  • Ensure documentation specifies displacement, laterality, and encounter type.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Fall from bicycle, initial encounter

W00.0XXA
Use to specify the external cause of the fracture.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Nondisplaced fracture of shaft of right clavicle, initial encounter for closed fracture

S42.024A
Use when imaging shows no displacement.

Displaced fracture of shaft of right clavicle, subsequent encounter for fracture with delayed healing

S42.021G
Use when healing is delayed, as documented by clinical findings.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Fracture of Right Clavicle to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S42.021A.

Impact

Clinical: May lead to inappropriate follow-up care, Regulatory: Non-compliance with coding standards, Financial: Potential for claim denials

Mitigation Strategy

Always specify whether the encounter is initial, subsequent, or for sequela

Impact

Reimbursement: May lead to lower reimbursement rates, Compliance: Increases risk of audit, Data Quality: Reduces accuracy of clinical data

Mitigation Strategy

Always document and code the specific part of the clavicle and the nature of the fracture.

Impact

High risk of audit if unspecified codes are used when specific codes are available

Mitigation Strategy

Ensure detailed documentation to support specific coding

Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.

Frequently Asked Questions

Common questions about ICD-10 coding for Fracture of Right Clavicle, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Fracture of Right Clavicle

Use these documentation templates to ensure complete and accurate documentation for Fracture of Right Clavicle. These templates include all required elements for proper coding and billing.

Initial encounter for displaced fracture of right clavicle

Specialty: Orthopedics

Required Elements

  • Mechanism of injury
  • Physical exam findings
  • Imaging results
  • Treatment plan

Example Documentation

Patient presents with a displaced fracture of the right clavicle following a fall from a bicycle. X-ray confirms displacement. Plan includes orthopedic consultation and application of a sling.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Right clavicle fracture, apply sling.
Good Documentation Example
Displaced fracture of the shaft of the right clavicle, initial encounter following fall from bicycle. X-ray confirms displacement. Ortho consult for possible ORIF.
Explanation
The good example provides specific details about the fracture, its location, and the treatment plan, improving clarity and coding accuracy.

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