ICD↔CPT crosswalk
CPT 23472: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 23472 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 23472 with a diagnosis that isn't covered typically denies as CARC 50 — not medically necessary.
National approximation. Coverage varies by MAC and state — confirm against the specific LCD/NCD and article that applies to your jurisdiction and date of service.
| ICD-10 | Description |
|---|---|
| C40.01 | Malignant neoplasm of scapula and long bones of right upper limb |
| C40.02 | Malignant neoplasm of scapula and long bones of left upper limb |
| C43.61 | Malignant melanoma of right upper limb, including shoulder |
| C43.62 | Malignant melanoma of left upper limb, including shoulder |
| C44.602 | Unspecified malignant neoplasm of skin of right upper limb, including shoulder |
| C44.609 | Unspecified malignant neoplasm of skin of left upper limb, including shoulder |
| C49.11 | Malignant neoplasm of connective and soft tissue of right upper limb, including shoulder |
| C49.12 | Malignant neoplasm of connective and soft tissue of left upper limb, including shoulder |
| C76.41 | Malignant neoplasm of right upper limb |
| C76.42 | Malignant neoplasm of left upper limb |
| D03.61 | Melanoma in situ of right upper limb, including shoulder |
| D03.62 | Melanoma in situ of left upper limb, including shoulder |
| M05.011 | Felty's syndrome, right shoulder |
| M05.012 | Felty's syndrome, left shoulder |
| M12.011 | Chronic postrheumatic arthropathy [Jaccoud], right shoulder |
| M12.012 | Chronic postrheumatic arthropathy [Jaccoud], left shoulder |
| M12.511 | Traumatic arthropathy, right shoulder |
| M12.512 | Traumatic arthropathy, left shoulder |
| M12.811 | Other specific arthropathies, not elsewhere classified, right shoulder |
| M12.812 | Other specific arthropathies, not elsewhere classified, left shoulder |
| M19.011 | Primary osteoarthritis, right shoulder |
| M19.012 | Primary osteoarthritis, left shoulder |
| M19.111 | Post-traumatic osteoarthritis, right shoulder |
| M19.112 | Post-traumatic osteoarthritis, left shoulder |
| M19.211 | Secondary osteoarthritis, right shoulder |
| M19.212 | Secondary osteoarthritis, left shoulder |
| M24.811 | Other specific joint derangements of right shoulder, not elsewhere classified |
| M24.812 | Other specific joint derangements of left shoulder, not elsewhere classified |
| M75.101 | Unspecified rotator cuff tear or rupture of right shoulder, not specified as traumatic |
| M75.102 | Unspecified rotator cuff tear or rupture of left shoulder, not specified as traumatic |
| M75.111 | Incomplete rotator cuff tear or rupture of right shoulder, not specified as traumatic |
| M75.112 | Incomplete rotator cuff tear or rupture of left shoulder, not specified as traumatic |
| M75.121 | Complete rotator cuff tear or rupture of right shoulder, not specified as traumatic |
| M75.122 | Complete rotator cuff tear or rupture of left shoulder, not specified as traumatic |
| M87.021 | Idiopathic aseptic necrosis of right humerus |
| M87.022 | Idiopathic aseptic necrosis of left humerus |
| S42.031K | Displaced fracture of lateral end of right clavicle, subsequent encounter for fracture with nonunion |
| S42.031P | Displaced fracture of lateral end of right clavicle, subsequent encounter for fracture with malunion |
| S42.032K | Displaced fracture of lateral end of left clavicle, subsequent encounter for fracture with nonunion |
| S42.032P | Displaced fracture of lateral end of left clavicle, subsequent encounter for fracture with malunion |
| S42.034K | Nondisplaced fracture of lateral end of right clavicle, subsequent encounter for fracture with nonunion |
| S42.034P | Nondisplaced fracture of lateral end of right clavicle, subsequent encounter for fracture with malunion |
| S42.035K | Nondisplaced fracture of lateral end of left clavicle, subsequent encounter for fracture with nonunion |
| S42.035P | Nondisplaced fracture of lateral end of left clavicle, subsequent encounter for fracture with malunion |
| S42.111K | Displaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with nonunion |
| S42.111P | Displaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with malunion |
| S42.112K | Displaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with nonunion |
| S42.112P | Displaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with malunion |
| S42.114K | Nondisplaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with nonunion |
| S42.114P | Nondisplaced fracture of body of scapula, right shoulder, subsequent encounter for fracture with malunion |
| S42.115K | Nondisplaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with nonunion |
| S42.115P | Nondisplaced fracture of body of scapula, left shoulder, subsequent encounter for fracture with malunion |
| S42.121K | Displaced fracture of acromial process, right shoulder, subsequent encounter for fracture with nonunion |
| S42.121P | Displaced fracture of acromial process, right shoulder, subsequent encounter for fracture with malunion |
| S42.122K | Displaced fracture of acromial process, left shoulder, subsequent encounter for fracture with nonunion |
| S42.122P | Displaced fracture of acromial process, left shoulder, subsequent encounter for fracture with malunion |
| S42.124K | Nondisplaced fracture of acromial process, right shoulder, subsequent encounter for fracture with nonunion |
| S42.124P | Nondisplaced fracture of acromial process, right shoulder, subsequent encounter for fracture with malunion |
| S42.125K | Nondisplaced fracture of acromial process, left shoulder, subsequent encounter for fracture with nonunion |
| S42.125P | Nondisplaced fracture of acromial process, left shoulder, subsequent encounter for fracture with malunion |
| S42.131K | Displaced fracture of coracoid process, right shoulder, subsequent encounter for fracture with nonunion |
| S42.131P | Displaced fracture of coracoid process, right shoulder, subsequent encounter for fracture with malunion |
| S42.132K | Displaced fracture of coracoid process, left shoulder, subsequent encounter for fracture with nonunion |
| S42.132P | Displaced fracture of coracoid process, left shoulder, subsequent encounter for fracture with malunion |
| S42.134K | Nondisplaced fracture of coracoid process, right shoulder, subsequent encounter for fracture with nonunion |
| S42.134P | Nondisplaced fracture of coracoid process, right shoulder, subsequent encounter for fracture with malunion |
| S42.135K | Nondisplaced fracture of coracoid process, left shoulder, subsequent encounter for fracture with nonunion |
| S42.135P | Nondisplaced fracture of coracoid process, left shoulder, subsequent encounter for fracture with malunion |
| S42.141K | Displaced fracture of glenoid cavity of scapula, right shoulder, subsequent encounter for fracture with nonunion |
| S42.141P | Displaced fracture of glenoid cavity of scapula, right shoulder, subsequent encounter for fracture with malunion |
| S42.142K | Displaced fracture of glenoid cavity of scapula, left shoulder, subsequent encounter for fracture with nonunion |
| S42.142P | Displaced fracture of glenoid cavity of scapula, left shoulder, subsequent encounter for fracture with malunion |
| S42.144K | Nondisplaced fracture of glenoid cavity of scapula, right shoulder, subsequent encounter for fracture with nonunion |
| S42.144P | Nondisplaced fracture of glenoid cavity of scapula, right shoulder, subsequent encounter for fracture with malunion |
| S42.145K | Nondisplaced fracture of glenoid cavity of scapula, left shoulder, subsequent encounter for fracture with nonunion |
| S42.145P | Nondisplaced fracture of glenoid cavity of scapula, left shoulder, subsequent encounter for fracture with malunion |
| S42.151K | Displaced fracture of neck of scapula, right shoulder, subsequent encounter for fracture with nonunion |
| S42.151P | Displaced fracture of neck of scapula, right shoulder, subsequent encounter for fracture with malunion |
| S42.152K | Displaced fracture of neck of scapula, left shoulder, subsequent encounter for fracture with nonunion |
| S42.152P | Displaced fracture of neck of scapula, left shoulder, subsequent encounter for fracture with malunion |
| S42.154K | Nondisplaced fracture of neck of scapula, right shoulder, subsequent encounter for fracture with nonunion |
| S42.154P | Nondisplaced fracture of neck of scapula, right shoulder, subsequent encounter for fracture with malunion |
| S42.155K | Nondisplaced fracture of neck of scapula, left shoulder, subsequent encounter for fracture with nonunion |
| S42.155P | Nondisplaced fracture of neck of scapula, left shoulder, subsequent encounter for fracture with malunion |
| S42.191K | Fracture of other part of scapula, right shoulder, subsequent encounter for fracture with nonunion |
| S42.191P | Fracture of other part of scapula, right shoulder, subsequent encounter for fracture with malunion |
| S42.192K | Fracture of other part of scapula, left shoulder, subsequent encounter for fracture with nonunion |
| S42.192P | Fracture of other part of scapula, left shoulder, subsequent encounter for fracture with malunion |
| S42.201A | Unspecified fracture of upper end of right humerus, initial encounter for closed fracture |
| S42.201B | Unspecified fracture of upper end of right humerus, initial encounter for open fracture |
| S42.201D | Unspecified fracture of upper end of right humerus, subsequent encounter for fracture with routine healing |
| S42.201G | Unspecified fracture of upper end of right humerus, subsequent encounter for fracture with delayed healing |
| S42.201K | Unspecified fracture of upper end of right humerus, subsequent encounter for fracture with nonunion |
| S42.201P | Unspecified fracture of upper end of right humerus, subsequent encounter for fracture with malunion |
| S42.201S | Unspecified fracture of upper end of right humerus, sequela |
| S42.202A | Unspecified fracture of upper end of left humerus, initial encounter for closed fracture |
| S42.202B | Unspecified fracture of upper end of left humerus, initial encounter for open fracture |
| S42.202D | Unspecified fracture of upper end of left humerus, subsequent encounter for fracture with routine healing |
| S42.202G | Unspecified fracture of upper end of left humerus, subsequent encounter for fracture with delayed healing |
| S42.202K | Unspecified fracture of upper end of left humerus, subsequent encounter for fracture with nonunion |
| S42.202P | Unspecified fracture of upper end of left humerus, subsequent encounter for fracture with malunion |
| S42.202S | Unspecified fracture of upper end of left humerus, sequela |
| S42.211A | Unspecified displaced fracture of surgical neck of right humerus, initial encounter for closed fracture |
| S42.211B | Unspecified displaced fracture of surgical neck of right humerus, initial encounter for open fracture |
| S42.211D | Unspecified displaced fracture of surgical neck of right humerus, subsequent encounter for fracture with routine healing |
| S42.211G | Unspecified displaced fracture of surgical neck of right humerus, subsequent encounter for fracture with delayed healing |
| S42.211K | Unspecified displaced fracture of surgical neck of right humerus, subsequent encounter for fracture with nonunion |
| S42.211P | Unspecified displaced fracture of surgical neck of right humerus, subsequent encounter for fracture with malunion |
| S42.211S | Unspecified displaced fracture of surgical neck of right humerus, sequela |
| S42.212A | Unspecified displaced fracture of surgical neck of left humerus, initial encounter for closed fracture |
| S42.212B | Unspecified displaced fracture of surgical neck of left humerus, initial encounter for open fracture |
| S42.212D | Unspecified displaced fracture of surgical neck of left humerus, subsequent encounter for fracture with routine healing |
| S42.212G | Unspecified displaced fracture of surgical neck of left humerus, subsequent encounter for fracture with delayed healing |
| S42.212K | Unspecified displaced fracture of surgical neck of left humerus, subsequent encounter for fracture with nonunion |
| S42.212P | Unspecified displaced fracture of surgical neck of left humerus, subsequent encounter for fracture with malunion |
| S42.212S | Unspecified displaced fracture of surgical neck of left humerus, sequela |
| S42.214A | Unspecified nondisplaced fracture of surgical neck of right humerus, initial encounter for closed fracture |
| S42.214B | Unspecified nondisplaced fracture of surgical neck of right humerus, initial encounter for open fracture |
| S42.214D | Unspecified nondisplaced fracture of surgical neck of right humerus, subsequent encounter for fracture with routine healing |
| S42.214G | Unspecified nondisplaced fracture of surgical neck of right humerus, subsequent encounter for fracture with delayed healing |
| S42.214K | Unspecified nondisplaced fracture of surgical neck of right humerus, subsequent encounter for fracture with nonunion |
| S42.214P | Unspecified nondisplaced fracture of surgical neck of right humerus, subsequent encounter for fracture with malunion |
| S42.214S | Unspecified nondisplaced fracture of surgical neck of right humerus, sequela |
| S42.215A | Unspecified nondisplaced fracture of surgical neck of left humerus, initial encounter for closed fracture |
| S42.215B | Unspecified nondisplaced fracture of surgical neck of left humerus, initial encounter for open fracture |
| S42.215D | Unspecified nondisplaced fracture of surgical neck of left humerus, subsequent encounter for fracture with routine healing |
| S42.215G | Unspecified nondisplaced fracture of surgical neck of left humerus, subsequent encounter for fracture with delayed healing |
| S42.215K | Unspecified nondisplaced fracture of surgical neck of left humerus, subsequent encounter for fracture with nonunion |
| S42.215P | Unspecified nondisplaced fracture of surgical neck of left humerus, subsequent encounter for fracture with malunion |
| S42.215S | Unspecified nondisplaced fracture of surgical neck of left humerus, sequela |
| S42.221A | 2-part displaced fracture of surgical neck of right humerus, initial encounter for closed fracture |
| S42.221B | 2-part displaced fracture of surgical neck of right humerus, initial encounter for open fracture |
| S42.221D | 2-part displaced fracture of surgical neck of right humerus, subsequent encounter for fracture with routine healing |
| S42.221G | 2-part displaced fracture of surgical neck of right humerus, subsequent encounter for fracture with delayed healing |
| S42.221K | 2-part displaced fracture of surgical neck of right humerus, subsequent encounter for fracture with nonunion |
| S42.221P | 2-part displaced fracture of surgical neck of right humerus, subsequent encounter for fracture with malunion |
| S42.221S | 2-part displaced fracture of surgical neck of right humerus, sequela |
| S42.222A | 2-part displaced fracture of surgical neck of left humerus, initial encounter for closed fracture |
| S42.222B | 2-part displaced fracture of surgical neck of left humerus, initial encounter for open fracture |
| S42.222D | 2-part displaced fracture of surgical neck of left humerus, subsequent encounter for fracture with routine healing |
| S42.222G | 2-part displaced fracture of surgical neck of left humerus, subsequent encounter for fracture with delayed healing |
| S42.222K | 2-part displaced fracture of surgical neck of left humerus, subsequent encounter for fracture with nonunion |
| S42.222P | 2-part displaced fracture of surgical neck of left humerus, subsequent encounter for fracture with malunion |
| S42.222S | 2-part displaced fracture of surgical neck of left humerus, sequela |
| S42.224A | 2-part nondisplaced fracture of surgical neck of right humerus, initial encounter for closed fracture |
| S42.224B | 2-part nondisplaced fracture of surgical neck of right humerus, initial encounter for open fracture |
| S42.224D | 2-part nondisplaced fracture of surgical neck of right humerus, subsequent encounter for fracture with routine healing |
| S42.224G | 2-part nondisplaced fracture of surgical neck of right humerus, subsequent encounter for fracture with delayed healing |
| S42.224K | 2-part nondisplaced fracture of surgical neck of right humerus, subsequent encounter for fracture with nonunion |
| S42.224P | 2-part nondisplaced fracture of surgical neck of right humerus, subsequent encounter for fracture with malunion |
| S42.224S | 2-part nondisplaced fracture of surgical neck of right humerus, sequela |
| S42.225A | 2-part nondisplaced fracture of surgical neck of left humerus, initial encounter for closed fracture |
| S42.225B | 2-part nondisplaced fracture of surgical neck of left humerus, initial encounter for open fracture |
| S42.225D | 2-part nondisplaced fracture of surgical neck of left humerus, subsequent encounter for fracture with routine healing |
| S42.225G | 2-part nondisplaced fracture of surgical neck of left humerus, subsequent encounter for fracture with delayed healing |
| S42.225K | 2-part nondisplaced fracture of surgical neck of left humerus, subsequent encounter for fracture with nonunion |
| S42.225P | 2-part nondisplaced fracture of surgical neck of left humerus, subsequent encounter for fracture with malunion |
| S42.225S | 2-part nondisplaced fracture of surgical neck of left humerus, sequela |
| S42.231A | 3-part fracture of surgical neck of right humerus, initial encounter for closed fracture |
| S42.231B | 3-part fracture of surgical neck of right humerus, initial encounter for open fracture |
| S42.231D | 3-part fracture of surgical neck of right humerus, subsequent encounter for fracture with routine healing |
| S42.231G | 3-part fracture of surgical neck of right humerus, subsequent encounter for fracture with delayed healing |
| S42.231K | 3-part fracture of surgical neck of right humerus, subsequent encounter for fracture with nonunion |
| S42.231P | 3-part fracture of surgical neck of right humerus, subsequent encounter for fracture with malunion |
| S42.231S | 3-part fracture of surgical neck of right humerus, sequela |
| S42.232A | 3-part fracture of surgical neck of left humerus, initial encounter for closed fracture |
| S42.232B | 3-part fracture of surgical neck of left humerus, initial encounter for open fracture |
| S42.232D | 3-part fracture of surgical neck of left humerus, subsequent encounter for fracture with routine healing |
| S42.232G | 3-part fracture of surgical neck of left humerus, subsequent encounter for fracture with delayed healing |
| S42.232K | 3-part fracture of surgical neck of left humerus, subsequent encounter for fracture with nonunion |
| S42.232P | 3-part fracture of surgical neck of left humerus, subsequent encounter for fracture with malunion |
| S42.232S | 3-part fracture of surgical neck of left humerus, sequela |
| S42.241A | 4-part fracture of surgical neck of right humerus, initial encounter for closed fracture |
| S42.241B | 4-part fracture of surgical neck of right humerus, initial encounter for open fracture |
| S42.241D | 4-part fracture of surgical neck of right humerus, subsequent encounter for fracture with routine healing |
| S42.241G | 4-part fracture of surgical neck of right humerus, subsequent encounter for fracture with delayed healing |
| S42.241K | 4-part fracture of surgical neck of right humerus, subsequent encounter for fracture with nonunion |
| S42.241P | 4-part fracture of surgical neck of right humerus, subsequent encounter for fracture with malunion |
| S42.241S | 4-part fracture of surgical neck of right humerus, sequela |
| S42.242A | 4-part fracture of surgical neck of left humerus, initial encounter for closed fracture |
| S42.242B | 4-part fracture of surgical neck of left humerus, initial encounter for open fracture |
| S42.242D | 4-part fracture of surgical neck of left humerus, subsequent encounter for fracture with routine healing |
| S42.242G | 4-part fracture of surgical neck of left humerus, subsequent encounter for fracture with delayed healing |
| S42.242K | 4-part fracture of surgical neck of left humerus, subsequent encounter for fracture with nonunion |
| S42.242P | 4-part fracture of surgical neck of left humerus, subsequent encounter for fracture with malunion |
| S42.242S | 4-part fracture of surgical neck of left humerus, sequela |
| S42.251A | Displaced fracture of greater tuberosity of right humerus, initial encounter for closed fracture |
| S42.251B | Displaced fracture of greater tuberosity of right humerus, initial encounter for open fracture |
| S42.251D | Displaced fracture of greater tuberosity of right humerus, subsequent encounter for fracture with routine healing |
| S42.251G | Displaced fracture of greater tuberosity of right humerus, subsequent encounter for fracture with delayed healing |
| S42.251K | Displaced fracture of greater tuberosity of right humerus, subsequent encounter for fracture with nonunion |
| S42.251P | Displaced fracture of greater tuberosity of right humerus, subsequent encounter for fracture with malunion |
| S42.251S | Displaced fracture of greater tuberosity of right humerus, sequela |
| S42.252A | Displaced fracture of greater tuberosity of left humerus, initial encounter for closed fracture |
| S42.252B | Displaced fracture of greater tuberosity of left humerus, initial encounter for open fracture |
| S42.252D | Displaced fracture of greater tuberosity of left humerus, subsequent encounter for fracture with routine healing |
| S42.252G | Displaced fracture of greater tuberosity of left humerus, subsequent encounter for fracture with delayed healing |
| S42.252K | Displaced fracture of greater tuberosity of left humerus, subsequent encounter for fracture with nonunion |
| S42.252P | Displaced fracture of greater tuberosity of left humerus, subsequent encounter for fracture with malunion |
| S42.252S | Displaced fracture of greater tuberosity of left humerus, sequela |
| S42.254A | Nondisplaced fracture of greater tuberosity of right humerus, initial encounter for closed fracture |
| S42.254B | Nondisplaced fracture of greater tuberosity of right humerus, initial encounter for open fracture |
| S42.254D | Nondisplaced fracture of greater tuberosity of right humerus, subsequent encounter for fracture with routine healing |
| S42.254G | Nondisplaced fracture of greater tuberosity of right humerus, subsequent encounter for fracture with delayed healing |
| S42.254K | Nondisplaced fracture of greater tuberosity of right humerus, subsequent encounter for fracture with nonunion |
| S42.254P | Nondisplaced fracture of greater tuberosity of right humerus, subsequent encounter for fracture with malunion |
| S42.254S | Nondisplaced fracture of greater tuberosity of right humerus, sequela |
| S42.255A | Nondisplaced fracture of greater tuberosity of left humerus, initial encounter for closed fracture |
| S42.255B | Nondisplaced fracture of greater tuberosity of left humerus, initial encounter for open fracture |
| S42.255D | Nondisplaced fracture of greater tuberosity of left humerus, subsequent encounter for fracture with routine healing |
| S42.255G | Nondisplaced fracture of greater tuberosity of left humerus, subsequent encounter for fracture with delayed healing |
| S42.255K | Nondisplaced fracture of greater tuberosity of left humerus, subsequent encounter for fracture with nonunion |
| S42.255P | Nondisplaced fracture of greater tuberosity of left humerus, subsequent encounter for fracture with malunion |
| S42.255S | Nondisplaced fracture of greater tuberosity of left humerus, sequela |
| S42.261A | Displaced fracture of lesser tuberosity of right humerus, initial encounter for closed fracture |
| S42.261B | Displaced fracture of lesser tuberosity of right humerus, initial encounter for open fracture |
| S42.261D | Displaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with routine healing |
| S42.261G | Displaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with delayed healing |
| S42.261K | Displaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with nonunion |
| S42.261P | Displaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with malunion |
| S42.261S | Displaced fracture of lesser tuberosity of right humerus, sequela |
| S42.262A | Displaced fracture of lesser tuberosity of left humerus, initial encounter for closed fracture |
| S42.262B | Displaced fracture of lesser tuberosity of left humerus, initial encounter for open fracture |
| S42.262D | Displaced fracture of lesser tuberosity of left humerus, subsequent encounter for fracture with routine healing |
| S42.262G | Displaced fracture of lesser tuberosity of left humerus, subsequent encounter for fracture with delayed healing |
| S42.262K | Displaced fracture of lesser tuberosity of left humerus, subsequent encounter for fracture with nonunion |
| S42.262P | Displaced fracture of lesser tuberosity of left humerus, subsequent encounter for fracture with malunion |
| S42.262S | Displaced fracture of lesser tuberosity of left humerus, sequela |
| S42.264A | Nondisplaced fracture of lesser tuberosity of right humerus, initial encounter for closed fracture |
| S42.264B | Nondisplaced fracture of lesser tuberosity of right humerus, initial encounter for open fracture |
| S42.264D | Nondisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with routine healing |
| S42.264G | Nondisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with delayed healing |
| S42.264K | Nondisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with nonunion |
| S42.264P | Nondisplaced fracture of lesser tuberosity of right humerus, subsequent encounter for fracture with malunion |
| S42.264S | Nondisplaced fracture of lesser tuberosity of right humerus, sequela |
| S42.265A | Nondisplaced fracture of lesser tuberosity of left humerus, initial encounter for closed fracture |
| S42.265B | Nondisplaced fracture of lesser tuberosity of left humerus, initial encounter for open fracture |
| S42.265D | Nondisplaced fracture of lesser tuberosity of left humerus, subsequent encounter for fracture with routine healing |
| S42.265G | Nondisplaced fracture of lesser tuberosity of left humerus, subsequent encounter for fracture with delayed healing |
| S42.265K | Nondisplaced fracture of lesser tuberosity of left humerus, subsequent encounter for fracture with nonunion |
| S42.265P | Nondisplaced fracture of lesser tuberosity of left humerus, subsequent encounter for fracture with malunion |
| S42.265S | Nondisplaced fracture of lesser tuberosity of left humerus, sequela |
| S42.291A | Other displaced fracture of upper end of right humerus, initial encounter for closed fracture |
| S42.291B | Other displaced fracture of upper end of right humerus, initial encounter for open fracture |
| S42.291D | Other displaced fracture of upper end of right humerus, subsequent encounter for fracture with routine healing |
| S42.291G | Other displaced fracture of upper end of right humerus, subsequent encounter for fracture with delayed healing |
| S42.291K | Other displaced fracture of upper end of right humerus, subsequent encounter for fracture with nonunion |
| S42.291P | Other displaced fracture of upper end of right humerus, subsequent encounter for fracture with malunion |
| S42.291S | Other displaced fracture of upper end of right humerus, sequela |
| S42.292A | Other displaced fracture of upper end of left humerus, initial encounter for closed fracture |
| S42.292B | Other displaced fracture of upper end of left humerus, initial encounter for open fracture |
| S42.292D | Other displaced fracture of upper end of left humerus, subsequent encounter for fracture with routine healing |
| S42.292G | Other displaced fracture of upper end of left humerus, subsequent encounter for fracture with delayed healing |
| S42.292K | Other displaced fracture of upper end of left humerus, subsequent encounter for fracture with nonunion |
| S42.292P | Other displaced fracture of upper end of left humerus, subsequent encounter for fracture with malunion |
| S42.292S | Other displaced fracture of upper end of left humerus, sequela |
| S42.294A | Other nondisplaced fracture of upper end of right humerus, initial encounter for closed fracture |
| S42.294B | Other nondisplaced fracture of upper end of right humerus, initial encounter for open fracture |
| S42.294D | Other nondisplaced fracture of upper end of right humerus, subsequent encounter for fracture with routine healing |
| S42.294G | Other nondisplaced fracture of upper end of right humerus, subsequent encounter for fracture with delayed healing |
| S42.294K | Other nondisplaced fracture of upper end of right humerus, subsequent encounter for fracture with nonunion |
| S42.294P | Other nondisplaced fracture of upper end of right humerus, subsequent encounter for fracture with malunion |
| S42.294S | Other nondisplaced fracture of upper end of right humerus, sequela |
| S42.295A | Other nondisplaced fracture of upper end of left humerus, initial encounter for closed fracture |
| S42.295B | Other nondisplaced fracture of upper end of left humerus, initial encounter for open fracture |
| S42.295D | Other nondisplaced fracture of upper end of left humerus, subsequent encounter for fracture with routine healing |
| S42.295G | Other nondisplaced fracture of upper end of left humerus, subsequent encounter for fracture with delayed healing |
| S42.295K | Other nondisplaced fracture of upper end of left humerus, subsequent encounter for fracture with nonunion |
| S42.295P | Other nondisplaced fracture of upper end of left humerus, subsequent encounter for fracture with malunion |
| S42.295S | Other nondisplaced fracture of upper end of left humerus, sequela |
| Z96.611 | Presence of right artificial shoulder joint |
| Z96.612 | Presence of left artificial shoulder joint |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT 23472?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 272 ICD-10 diagnosis codes that support medical necessity for CPT 23472. The covered codes are listed on this page. Coverage varies by MAC/state — always confirm against the policy that applies to you.
What is a medical-necessity (LCD/NCD) crosswalk?
A claim whose procedure isn't supported by a covered diagnosis denies as "not medically necessary" (CARC 50). CMS coverage policies define which diagnoses justify a procedure; this page is the ICD-10 → CPT 23472 view of that relationship.
Catch medical-necessity denials before you bill. CareNiva scrubs claims against LCD/NCD coverage and flags unsupported diagnoses — in the same platform you run visits and billing.
More free billing tools: all crosswalks · NCCI edits · Medicare fees · denial codes
Informational only, not coding, billing, or legal advice. Based on CMS Medicare Coverage Database data; verify the current LCD/NCD for your MAC before billing.
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