S46.012D — Strain of muscle(s) and tendon(s) of the rotator cuff of left shoulder, subsequent encounter
S46.012D is a billable, specific ICD-10-CM code for strain of muscle(s) and tendon(s) of the rotator cuff of left shoulder, subsequent encounter. It is valid for submission on a claim.
7th character "D" — subsequent encounter
The appropriate 7th character is to be added to each code from category S46
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S46.012D 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.
Medicare coverage
S46.012D is named in 5 Medicare coverage policies — 5 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
Related codes at this level
Codes that share S46.012. If S46.012D is not quite right, the correct code is usually one of these.
Questions about S46.012D
- Is S46.012D a billable ICD-10-CM code?
- Yes. S46.012D is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S46.012D 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).