S43.429A

S43.429A: Sprain of unspecified rotator cuff capsule, initial encounter

Billable / specific codeICD-10-CM

S43.429A is a billable, specific ICD-10-CM code for sprain of unspecified rotator cuff capsule, initial encounter. It is valid for submission on a claim.

Check S43.429A with the rest of the claim: free scrubber

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

Excludes1 inherited from the categories above S43.429A

A category’s note binds every code beneath it.

Written on S43.42: Sprain of rotator cuff capsule

rotator cuff syndrome (complete) (incomplete), not specified as traumatic (M75.1-)

Excludes2 inherited from the categories above S43.429A

Not part of this code, but both may be coded when both are present.

Written on S43.42: Sprain of rotator cuff capsule

injury of tendon of rotator cuff (S46.0-)

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

No CMS-HCC V28 category: this code does not change a RAF score.

Code history

Unchanged in every release from FY2024 to FY2027.