Is S41.031A a billable ICD-10-CM code?

Yes. S41.031A is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S41.031A sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the shoulder and upper arm (S40-S49).

What cannot be coded together with S41.031A?

S41.031A carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S41.031A (S41) and apply to it just the same.

S41.031A

S41.031A — Puncture wound without foreign body of right shoulder, initial encounter

Billable / specific codeICD-10-CMright

S41.031A is a billable, specific ICD-10-CM code for puncture wound without foreign body of right shoulder, initial encounter. It is valid for submission on a claim.

7th character "A" — initial encounter

The appropriate 7th character is to be added to each code from category S41

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 inherited from the categories above S41.031A

These are not written on S41.031A, but they bind it: a note on a category applies to every code beneath it. Billing S41.031A with anything listed here is a denial.

Written on S41 — Open wound of shoulder and upper arm

traumatic amputation of shoulder and upper arm (S48.-)

Excludes2 inherited from the categories above S41.031A

Also inherited, and the opposite of Excludes1: these conditions are not part of S41.031A, but a patient can have both, so you may code both.

Written on S41 — Open wound of shoulder and upper arm

open fracture of shoulder and upper arm (S42.- with 7th character B or C)

Risk adjustment

S41.031A does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

S41.031A is named in 11 Medicare coverage policies — 11 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52438Billing and Coding: Tetanus Immunization
A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy
A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines

Code history

S41.031A has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share S41.031. If S41.031A is not quite right, the correct code is usually one of these.

Questions about S41.031A

Is S41.031A a billable ICD-10-CM code?: Yes. S41.031A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S41.031A sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the shoulder and upper arm (S40-S49).
What cannot be coded together with S41.031A?: S41.031A carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S41.031A (S41) and apply to it just the same.