S43.492D

S43.492D: Other sprain of left shoulder joint, subsequent encounter

Billable / specific codeICD-10-CMPOA exemptleft

S43.492D is a billable, specific ICD-10-CM code for other sprain of left shoulder joint, subsequent encounter. It is valid for submission on a claim.

Check S43.492D with the rest of the claim: free scrubber

7th character "D": subsequent 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 S43.492D

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

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.

Medicare coverage

S43.492D is named in 4 Medicare coverage policies: 4 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
A57311Billing and Coding: Physical Therapy - Home Health

Code history

Unchanged in every release from FY2024 to FY2027.