Is S46 a billable ICD-10-CM code?

No. S46 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does S46 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).

S46

S46 — Injury of muscle, fascia and tendon at shoulder and upper arm level

Non-billable headerICD-10-CM

S46 is a non-billable header ICD-10-CM code for injury of muscle, fascia and tendon at shoulder and upper arm level. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

The appropriate 7th character is to be added to each code from category S46

A: initial encounter
D: subsequent encounter
S: sequela

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

injury of muscle, fascia and tendon at elbow (S56.-)
sprain of joints and ligaments of shoulder girdle (S43.9)

Code also

Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.

any associated open wound (S41.-)

Other codes that can never be billed with S46

These codes carry an Excludes1 note pointing at S46. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S46 alone.

M75.1Rotator cuff tear or rupture, not specified as traumatic

Risk adjustment

S46 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.

Code to one of these instead S46

6 child codes. Green means billable.

Questions about S46

Is S46 a billable ICD-10-CM code?: No. S46 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does S46 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).