Is S43.499S a billable ICD-10-CM code?

Yes. S43.499S is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S43.499S 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).

S43.499S

S43.499S — Other sprain of unspecified shoulder joint, sequela

Billable / specific codeICD-10-CMPOA exemptunspecified

S43.499S is a billable, specific ICD-10-CM code for other sprain of unspecified shoulder joint, sequela. It is valid for submission on a claim.

7th character "S" — sequela

The appropriate 7th character is to be added to each code from category S43

A: initial encounter
D: subsequent encounter
S: sequela

Risk adjustment

S43.499S 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 S43.499S is not quite right, the correct code is usually one of these.

Questions about S43.499S

Is S43.499S a billable ICD-10-CM code?: Yes. S43.499S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S43.499S 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).