Unspecified fracture of upper end of right humerus, initial encounter
ICD-10 Code: S42.201A · Body Part: Shoulder
QME Evaluation Process
Shoulder ROM testing, imaging for healing and alignment. UE impairment based on shoulder ROM loss. Consider arthroplasty rating if applicable.
Typical Impairment Rating
10-25% UE (6-15% WPI)
AMA Guides Edition
5th Edition
Common Treatments
Related Conditions
Body Part Guide
Shoulder Evaluation Guide
Impairment rating methods, common conditions, and QME evaluation protocols
QME Specialties for Unspecified fracture of upper end of right humerus, initial encounter
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What is Unspecified fracture of upper end of right humerus, initial encounter (S42.201A)?
Unspecified fracture of upper end of right humerus, initial encounter is an ICD-10 diagnosis code (S42.201A) classified under Musculoskeletal conditions. It affects the Shoulder and is commonly encountered in California workers' compensation claims. QME physicians evaluate this condition using AMA Guides 5th Edition protocols.
How is S42.201A rated for impairment?
The typical whole person impairment (WPI) range for Unspecified fracture of upper end of right humerus, initial encounter is 10-25% UE (6-15% WPI). The exact rating depends on clinical findings, imaging, and the evaluation method (DRE or ROM) chosen by the QME physician per AMA Guides 5th Edition.
What is the QME evaluation process for S42.201A?
Shoulder ROM testing, imaging for healing and alignment. UE impairment based on shoulder ROM loss. Consider arthroplasty rating if applicable.
What treatments are common for Unspecified fracture of upper end of right humerus, initial encounter?
Common treatments for Unspecified fracture of upper end of right humerus, initial encounter include Sling immobilization, ORIF, Shoulder hemiarthroplasty, Physical therapy. Treatment appropriateness and outcomes are considered during the QME evaluation when determining permanent and stationary status and apportionment.