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S23.170D vs S43.6

S23.170D (Subluxation of T12/L1 thoracic vertebra, subsequent encounter) compared with S43.6 (Sprain of sternoclavicular joint), from the official CMS tabular data.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Summary

These codes can be reported together when both conditions are documented, because S23.170D lists S43.6 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named and billing status.S23.170D is “Subluxation of T12/L1 thoracic vertebra, subsequent encounter”; S43.6 is “Sprain of sternoclavicular joint”. S43.6 is a non-billable header; S23.170D is billable.

Registry fact

Can these codes be reported together?

Yes, when both are documented.S23.170D lists S43.6 under Excludes2: “dislocation, sprain of sternoclavicular joint (S43.2, S43.6)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

Yes.S23.170D’s tabular entry: “dislocation, sprain of sternoclavicular joint (S43.2, S43.6)”. The note covers S43.6.

Official ruleGuide: Excludes1 vs Excludes2

Is one a parent or header code?

One is a header.S43.6 is a non-billable header, but S23.170D is not one of its subdivisions.

Registry fact

Nothing found in 3 other checks; 1 check does not apply
Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code.

Official rule

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

S23.170D
Subluxation of T12/L1 thoracic vertebra, subsequent encounter
↔
S43.6
Sprain of sternoclavicular joint

What we found

Yes, when both are documented.S23.170D carries an Excludes2 note covering S43.6: “dislocation, sprain of sternoclavicular joint (S43.2, S43.6)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    ICD-10-CM Official Guidelines FY2027

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

Similar descriptions do not make codes interchangeable. The documentation and the official instructions decide which code applies.

Official descriptionDiffers
S23.170D

Subluxation of T12/L1 thoracic vertebra, subsequent encounter

S43.6

Sprain of sternoclavicular joint

StatusDiffers
S23.170D
Billable
S43.6
Non-billable header

A header is not reported on a claim; a code beneath it is.

Report instead: S43.60XA, S43.60XD, S43.60XS, S43.61XA, S43.61XD

Excludes2Differs
Only at S23.170D
  • fracture of thoracic vertebrae (S22.0-)
  • dislocation, sprain of sternoclavicular joint (S43.2, S43.6)
  • strain of muscle or tendon of thorax (S29.01-)
  • effects of foreign body in bronchus (T17.5)
  • effects of foreign body in esophagus (T18.1)
  • effects of foreign body in lung (T17.8)
  • effects of foreign body in trachea (T17.4)
  • injuries of axilla
  • injuries of clavicle
  • injuries of scapular region
  • injuries of shoulder
Only at S43.6
  • strain of muscle, fascia and tendon of shoulder and upper arm (S46.-)
  • injuries of elbow (S50-S59)
Shared by both codes (3 notes)
  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • insect bite or sting, venomous (T63.4)
Code alsoDiffers
Only at S23.170D
  • any associated:
  • open wound of thorax (S21.-)
  • spinal cord injury (S24.0-, S24.1-)
Only at S43.6

No note of its own beyond the shared notes

Shared by both codes (1 note)
  • any associated open wound
CategoryDiffers
S23.170D

S23 Dislocation and sprain of joints and ligaments of thorax

S43.6

S43 Dislocation and sprain of joints and ligaments of shoulder girdle

ChapterSame for both

S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)

IncludesDiffers
S23.170D
  • avulsion of joint or ligament of thorax
  • laceration of cartilage, joint or ligament of thorax
  • sprain of cartilage, joint or ligament of thorax
  • traumatic hemarthrosis of joint or ligament of thorax
  • traumatic rupture of joint or ligament of thorax
  • traumatic subluxation of joint or ligament of thorax
  • traumatic tear of joint or ligament of thorax
  • injuries of breast
  • injuries of chest (wall)
  • injuries of interscapular area
S43.6
  • avulsion of joint or ligament of shoulder girdle
  • laceration of cartilage, joint or ligament of shoulder girdle
  • sprain of cartilage, joint or ligament of shoulder girdle
  • traumatic hemarthrosis of joint or ligament of shoulder girdle
  • traumatic rupture of joint or ligament of shoulder girdle
  • traumatic subluxation of joint or ligament of shoulder girdle
  • traumatic tear of joint or ligament of shoulder girdle
  • injuries of axilla
  • injuries of scapular region
7th characterDiffers
S23.170D
  • The appropriate 7th character is to be added to each code from category S23
S43.6
  • The appropriate 7th character is to be added to each code from category S43

No Excludes1, Code first and Use additional code note at either code.

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on. In a row that differs, each code’s own notes are listed under it, and the notes every code shares are listed once beneath them.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources