S43.422A
S43.422A: Sprain of left rotator cuff capsule, initial encounter
Billable / specific codeICD-10-CMleft
S43.422A is a billable, specific ICD-10-CM code for sprain of left rotator cuff capsule, initial encounter. It is valid for submission on a claim.
Check S43.422A with the rest of the claim: free scrubber7th 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
Excludes1 inherited from the categories above S43.422A
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S43.422A
Not part of this code, but both may be coded when both are present.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
S43.422A is named in 5 Medicare coverage policies: 5 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53058Billing and Coding: Home Health Physical Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
- A56787Billing and Coding: Nonvascular Extremity Ultrasound
- A57079Billing and Coding: Injections - Tendon, Ligament, and Ganglion Cyst
Code history
Unchanged in every release from FY2024 to FY2027.