Is S43.316A a billable ICD-10-CM code?

Yes. S43.316A is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S43.316A 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).

S43.316A

S43.316A — Dislocation of unspecified scapula, initial encounter

Billable / specific codeICD-10-CM

S43.316A is a billable, specific ICD-10-CM code for dislocation of unspecified scapula, 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 S43

A: initial encounter
D: subsequent encounter
S: sequela

Excludes2 inherited from the categories above S43.316A

Also inherited, and the opposite of Excludes1: these conditions are not part of S43.316A, but a patient can have both, so you may code both.

Written on S43 — Dislocation and sprain of joints and ligaments of shoulder girdle

strain of muscle, fascia and tendon of shoulder and upper arm (S46.-)

Risk adjustment

S43.316A 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 history

S43.316A 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 S43.316. If S43.316A is not quite right, the correct code is usually one of these.

Questions about S43.316A

Is S43.316A a billable ICD-10-CM code?: Yes. S43.316A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S43.316A 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).