S43.499A
S43.499A — Other sprain of unspecified shoulder joint, initial encounter
Billable / specific codeICD-10-CMunspecified
S43.499A is a billable, specific ICD-10-CM code for other sprain of unspecified shoulder joint, 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
Risk adjustment
S43.499A 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.
Related codes at this level
Codes that share S43.499. If S43.499A is not quite right, the correct code is usually one of these.
Questions about S43.499A
- Is S43.499A a billable ICD-10-CM code?
- Yes. S43.499A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S43.499A 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).