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S42.431 ICD-10-CM Code: Displaced fracture (avulsion) of lateral epicondyle of right humerus

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FY 2026 Apr update / Injury, poisoning and certain other consequences of external causes (S00-T88) / Injuries to the shoulder and upper arm (S40-S49)

S42.431

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Displaced fracture (avulsion) of lateral epicondyle of right humerus

Displaced fracture (avulsion) of lateral epicondyle of right humerus

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
S42.4Fracture of lower end of humerus
S42.43Fracture (avulsion) of lateral epicondyle of humerus
S42.431Displaced fracture (avulsion) of lateral epicondyle of right humerus

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for S42.431 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for S42.431 in this effective period.

Related Child Codes

Official
S42.431ADisplaced fracture (avulsion) of lateral epicondyle of right humerus, initial encounter for closed fracture
S42.431BDisplaced fracture (avulsion) of lateral epicondyle of right humerus, initial encounter for open fracture
S42.431DDisplaced fracture (avulsion) of lateral epicondyle of right humerus, subsequent encounter for fracture with routine healing
S42.431GDisplaced fracture (avulsion) of lateral epicondyle of right humerus, subsequent encounter for fracture with delayed healing
S42.431KDisplaced fracture (avulsion) of lateral epicondyle of right humerus, subsequent encounter for fracture with nonunion

Includes

Official

ICD-10-CM does not list Includes notes for S42.431 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for S42.431 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for S42.431 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for S42.431 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for S42.431 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

S42.431 is the ICD-10-CM diagnosis code for displaced fracture (avulsion) of lateral epicondyle of right humerus. S42.431 sits in the ICD-10-CM chapter for injury, poisoning and certain other consequences of external causes (s00-t88), within the section covering injuries to the shoulder and upper arm (s40-s49).

Header codes like S42.431 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at S42.431's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for S42.431 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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