S43 vs S59
S43 (Dislocation and sprain of joints and ligaments of shoulder girdle) compared with S59 (Other and unspecified injuries of elbow and forearm), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. S43 carries an Excludes2 note covering S59: “injuries of elbow (S50-S59)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| S43Dislocation and sprain of joints and ligaments of shoulder girdle | S59Other and unspecified injuries of elbow and forearm | |
|---|---|---|
| Billing status | Non-billable header Report instead: S43.001A, S43.001D, S43.001S, S43.002A, S43.002D | Non-billable header Report instead: S59.001A, S59.001D, S59.001G, S59.001K, S59.001P |
| Classification | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Dislocation and sprain of joints and ligaments of shoulder girdle is a non-billable ICD-10-CM category code (S43). | Other and unspecified injuries of elbow and forearm is a non-billable ICD-10-CM category code (S59). |
| 7th character | The appropriate 7th character is to be added to each code from category S43 | The appropriate 7th character is to be added to each code from subcategories S59.0, S59.1, and S59.2 |
| Includes | 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 | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources