S46.012A

S46.012A: Strain of muscle(s) and tendon(s) of the rotator cuff of left shoulder, initial encounter

Billable / specific codeICD-10-CMleft

S46.012A is a billable, specific ICD-10-CM code for strain of muscle(s) and tendon(s) of the rotator cuff of left shoulder, initial encounter. It is valid for submission on a claim.

Check S46.012A 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 S46

A: initial encounter
D: subsequent encounter
S: sequela

Excludes2 inherited from the categories above S46.012A

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

Written on S46: Injury of muscle, fascia and tendon at shoulder and upper arm level

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

Risk adjustment

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

Medicare coverage

S46.012A is named in 5 Medicare coverage policies: 5 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
A57079Billing and Coding: Injections - Tendon, Ligament, and Ganglion Cyst

Code history

Unchanged in every release from FY2024 to FY2027.