Is S43.226 a billable ICD-10-CM code?

No. S43.226 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does S43.226 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).

S43.226

S43.226 — Posterior dislocation of unspecified sternoclavicular joint

Non-billable headerICD-10-CM

S43.226 is a non-billable header ICD-10-CM code for posterior dislocation of unspecified sternoclavicular joint. 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

Risk adjustment

S43.226 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.

Code to one of these instead S43.226

3 child codes. Green means billable.

Related codes at this level

Codes that share S43.22. If S43.226 is not quite right, the correct code is usually one of these.

Questions about S43.226

Is S43.226 a billable ICD-10-CM code?: No. S43.226 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does S43.226 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).