S46.9
S46.9 — Injury of unspecified muscle, fascia and tendon at shoulder and upper arm level
Non-billable headerICD-10-CMunspecified
S46.9 is a non-billable header ICD-10-CM code for injury of unspecified 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
Risk adjustment
S46.9 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 S46.9
4 child codes. Green means billable.
- S46.90Unspecified injury of unspecified muscle, fascia and tendon at shoulder and upper arm level
- S46.91Strain of unspecified muscle, fascia and tendon at shoulder and upper arm level
- S46.92Laceration of unspecified muscle, fascia and tendon at shoulder and upper arm level
- S46.99Other injury of unspecified muscle, fascia and tendon at shoulder and upper arm level
Related codes at this level
Codes that share S46. If S46.9 is not quite right, the correct code is usually one of these.
- S46.0Injury of muscle(s) and tendon(s) of the rotator cuff of shoulder
- S46.1Injury of muscle, fascia and tendon of long head of biceps
- S46.2Injury of muscle, fascia and tendon of other parts of biceps
- S46.3Injury of muscle, fascia and tendon of triceps
- S46.8Injury of other muscles, fascia and tendons at shoulder and upper arm level
Questions about S46.9
- Is S46.9 a billable ICD-10-CM code?
- No. S46.9 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S46.9 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).