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S43.005D vs T63.4

S43.005D (Unspecified dislocation of left shoulder joint, subsequent encounter) compared with T63.4 (Toxic effect of venom of other arthropods), 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 S43.005D lists T63.4 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named and billing status.S43.005D is “Unspecified dislocation of left shoulder joint, subsequent encounter”; T63.4 is “Toxic effect of venom of other arthropods”. T63.4 is a non-billable header; S43.005D is billable.

Registry fact

Can these codes be reported together?

Yes, when both are documented.S43.005D lists T63.4 under Excludes2: “insect bite or sting, venomous (T63.4)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. T63.4 carries 1 Excludes1 note covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.S43.005D’s tabular entry: “insect bite or sting, venomous (T63.4)”. The note covers T63.4.

Official ruleGuide: Excludes1 vs Excludes2

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.T63.4 is a non-billable header, but S43.005D 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?

Informational

Excludes2 relationship

S43.005D
Unspecified dislocation of left shoulder joint, subsequent encounter
↔
T63.4
Toxic effect of venom of other arthropods

What we found

Yes, when both are documented.S43.005D carries an Excludes2 note covering T63.4: “insect bite or sting, venomous (T63.4)”

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
S43.005D

Unspecified dislocation of left shoulder joint, subsequent encounter

T63.4

Toxic effect of venom of other arthropods

StatusDiffers
S43.005D
Billable
T63.4
Non-billable header

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

Report instead: T63.411A, T63.411D, T63.411S, T63.412A, T63.412D

Excludes1Differs
S43.005D

None at this code

T63.4
  • contact with and (suspected) exposure to toxic substances (Z77.-)
Excludes2Differs
S43.005D
  • strain of muscle, fascia and tendon of shoulder and upper arm (S46.-)
  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • injuries of elbow (S50-S59)
  • insect bite or sting, venomous (T63.4)
T63.4
  • ingestion of toxic animal or plant (T61.-, T62.-)
Use additional codeDiffers
S43.005D

None at this code

T63.4
  • code, if applicable, for anaphylactic shock (T78.2)
  • code(s):
  • for all associated manifestations of toxic effect, such as: respiratory conditions due to external agents (J60-J70)
Code alsoDiffers
S43.005D
  • any associated open wound
T63.4

None at this code

CategoryDiffers
S43.005D

S43 Dislocation and sprain of joints and ligaments of shoulder girdle

T63.4

T63 Toxic effect of contact with venomous animals and plants

ChapterSame for both

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

IncludesDiffers
S43.005D
  • 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
T63.4
  • bite or touch of venomous animal
  • pricked or stuck by thorn or leaf
7th characterDiffers
S43.005D
  • The appropriate 7th character is to be added to each code from category S43
T63.4
  • The appropriate 7th character is to be added to each code from category T63

No Code first 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