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Home/Diagnosis/ICD-10 Coding for Shoulder Sprain

ICD-10 Coding for Shoulder Sprain

S43.401A
S43.51xA

Complete ICD-10-CM coding and documentation guide for icd-10 coding for shoulder sprain includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Shoulder Ligament Injury
AC Joint Sprain
Glenohumeral Sprain
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Key Information: ICD-10 Coding for Shoulder Sprain

Essential facts and insights about ICD-10 Coding for Shoulder Sprain

Use ICD-10 code S43.401A for sprain of unspecified ligament of right shoulder, initial encounter, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Sprain of unspecified ligament of right shoulder, initial encounter

Billable Code
S43.401A
Billable

Diagnostic Criteria

clinical:
  • • Presence of ligament tenderness and positive ligament-specific tests
coding:
  • • Unspecified ligament of right shoulder

Applicable To

  • • Right shoulder ligament injury

Important Notes

  • • Ensure laterality and encounter type are specified to avoid unspecified codes.

Sprain of acromioclavicular joint of right shoulder, initial encounter

Billable Code
S43.51xA
Billable

Applicable To

  • • Right AC joint sprain

Important Notes

  • • Ensure documentation specifies the AC joint and laterality.
Ancillary Codes

Additional codes that may be used with this diagnosis

W19.xxxA

Unspecified fall

Use to describe the mechanism of injury, such as a fall.

W17.3xxA

Fall during sports

Use when the injury occurred during a sporting activity.

Frequently Asked Questions

What is the ICD-10 code for shoulder sprain?

The ICD-10 code for a shoulder sprain depends on the specific ligament and laterality involved, such as S43.401A for an unspecified ligament of the right shoulder.

How do you code a shoulder sprain with a fall?

Code the shoulder sprain with the appropriate S43 code and add an external cause code like W19.xxxA for the fall.

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