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S40.87 vs S41.152A

S40.87 (Other superficial bite of upper arm) compared with S41.152A (Open bite of left upper arm, initial encounter), 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 should not be reported together because S41.152A’s tabular entry lists S40.87 under Excludes1.

Official rule
What is different?

The conditions named and billing status.S40.87 is “Other superficial bite of upper arm”; S41.152A is “Open bite of left upper arm, initial encounter”. S40.87 is a non-billable header; S41.152A is billable.

Registry fact

Can these codes be reported together?

No.S41.152A’s entry carries an Excludes1 note covering S40.87: “superficial bite of upper arm (S40.87)”. Both may be reported only when the documentation shows the two conditions are unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

Yes.S41.152A’s tabular entry: “superficial bite of upper arm (S40.87)”. The note covers S40.87.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code. S40.87 carries 5 Excludes2 notes and S41.152A carries 5 Excludes2 notes covering other codes; the side-by-side table quotes them.

Official rule

Is one more specific?

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

Is one a parent or header code?

One is a header.S40.87 is a non-billable header, but S41.152A is not one of its subdivisions.

Registry fact

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?

Excludes1 — generally not reported together

Excludes1 conflict

S41.152A
Open bite of left upper arm, initial encounter
↔
S40.87
Other superficial bite of upper arm

What we found

No — do not report together.S41.152A carries an Excludes1 note covering S40.87: “superficial bite of upper arm (S40.87)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

What to review

Report one of the two. Both may be reported only when the documentation shows the two conditions are unrelated to each other.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes1 note means the two conditions are not ordinarily reported together for the same encounter, because the classification treats them as mutually exclusive forms of the same condition. The documented exception is when the two conditions are unrelated to each other.

Source / rule

CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Official guidance behind these answers

  • Section I.A.12.a — Excludes1 · applies to: Excludes1

    A type 1 Excludes note is a pure excludes note. It means “NOT CODED HERE!” An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. An exception to the Excludes1 definition is the circumstance when the two conditions are unrelated to each other. If it is not clear whether the two conditions involving an Excludes1 note are related or not, query the provider. For example, code F45.8, Other somatoform disorders, has an Excludes1 note for "sleep related teeth grinding (G47.63)," because "teeth grinding" is an inclusion term under F45.8. Only one of these two codes should be assigned for teeth grinding. However psychogenic dysmenorrhea is also an inclusion term under F45.8, and a patient could have both this condition and sleep related teeth grinding. In this case, the two conditions are clearly unrelated to each other, and so it would be appropriate to report F45.8 and G47.63 together.

    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
S40.87

Other superficial bite of upper arm

S41.152A

Open bite of left upper arm, initial encounter

StatusDiffers
S40.87
Non-billable header

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

Report instead: S40.871A, S40.871D, S40.871S, S40.872A, S40.872D

S41.152A
Billable
Excludes1Differs
S40.87
  • open bite of upper arm (S41.14)
S41.152A
  • superficial bite of upper arm (S40.87)
  • traumatic amputation of shoulder and upper arm (S48.-)
Excludes2Differs
S40.87
  • other superficial bite of shoulder (S40.27-)
  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • injuries of elbow (S50-S59)
  • insect bite or sting, venomous (T63.4)
S41.152A
  • open fracture of shoulder and upper arm (S42.- with 7th character B or C)
  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • injuries of elbow (S50-S59)
  • insect bite or sting, venomous (T63.4)
Code alsoDiffers
S40.87

None at this code

S41.152A
  • any associated wound infection
CategoryDiffers
S40.87

S40 Superficial injury of shoulder and upper arm

S41.152A

S41 Open wound of shoulder and upper arm

ChapterSame for both

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

IncludesSame for both
  • injuries of axilla
  • injuries of scapular region
7th characterDiffers
S40.87
  • The appropriate 7th character is to be added to each code from category S40
S41.152A
  • The appropriate 7th character is to be added to each code from category S41

No 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, notes every code shares are dimmed.

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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