S42.366PNondisplaced segmental fracture of shaft of humerus, unspecified arm, subsequent encounter for fracture with malunion

S42.366P is the ICD-10-CM diagnosis code for nondisplaced segmental fracture of shaft of humerus, unspecified arm, subsequent encounter for fracture with malunion. It belongs to category S42 (fracture of shoulder and upper arm), block S40-S49 (injuries to the shoulder and upper arm) and chapter 19 (injury, poisoning and certain other consequences of external causes). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

The 7th character "P" means subsequent encounter for fracture with malunion: use it for encounters after active treatment, while the patient is healing or recovering.

As a secondary diagnosis it is a CC (complication or comorbidity), which can move an inpatient stay into the "with CC" MS-DRG of its family, unless the principal diagnosis excludes it.

In MS-DRG v44.0, it is part of the grouping logic for DRG 564 (Other Musculoskeletal System and Connective Tissue Diagnoses with MCC, relative weight 1.4908), DRG 565 (Other Musculoskeletal System and Connective Tissue Diagnoses with CC, relative weight 0.9783) and DRG 566 (Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCC, relative weight 0.7378), in MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It is an unspecified code for which a more specific option (often laterality) exists, and the Medicare Code Editor flags it for review on inpatient claims.

It is exempt from present-on-admission (POA) reporting, so no POA indicator is required.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as 733.81 (malunion of fracture).