S43
S43: Dislocation and sprain of joints and ligaments of shoulder girdle
Non-billable headerICD-10-CM
S43 is a non-billable header ICD-10-CM code for dislocation and sprain of joints and ligaments of shoulder girdle. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.
This code requires a 7th character
The appropriate 7th character is to be added to each code from category S43
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes2: not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- strain of muscle, fascia and tendon of shoulder and upper arm (S46.-)
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- any associated open wound
Includes
Conditions this code covers.
- avulsion of joint or ligament of shoulder girdle
- laceration of cartilage, joint or ligament of shoulder girdle
- sprain of cartilage, joint or ligament of shoulder girdle
- traumatic hemarthrosis of joint or ligament of shoulder girdle
- traumatic rupture of joint or ligament of shoulder girdle
- traumatic subluxation of joint or ligament of shoulder girdle
- traumatic tear of joint or ligament of shoulder girdle
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Code history
Unchanged in every release from FY2024 to FY2027.
Code to one of these instead S43
9 child codes. Green means billable.
- S43.0Subluxation and dislocation of shoulder joint
- S43.1Subluxation and dislocation of acromioclavicular joint
- S43.2Subluxation and dislocation of sternoclavicular joint
- S43.3Subluxation and dislocation of other and unspecified parts of shoulder girdle
- S43.4Sprain of shoulder joint
- S43.5Sprain of acromioclavicular joint
- S43.6Sprain of sternoclavicular joint
- S43.8Sprain of other specified parts of shoulder girdle
- S43.9Sprain of unspecified parts of shoulder girdle