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S43.395A vs S43.395S

S43.395A (Dislocation of other parts of left shoulder girdle, initial encounter) compared with S43.395S (Dislocation of other parts of left shoulder girdle, sequela), from the official CMS tabular data. S43.395A and S43.395S code the same injury at a different phase of treatment. MedCoder-derived

Relationship

Review

Encounter relationship

S43.395A
Initial encounter
Dislocation of other parts of left shoulder girdle, initial encounter
S43.395S
Sequela
Dislocation of other parts of left shoulder girdle, sequela

Same underlying diagnosis, different encounter phase.

The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.

Source: ICD-10-CM Official Guidelines, Section I.C.19.a

Can these codes be reported together?

Same injury, other encounter phase. S43.395A and S43.395S code the same injury at a different phase of treatment, set by the 7th character.

The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.

Side by side

S43.395ADislocation of other parts of left shoulder girdle, initial encounterS43.395SDislocation of other parts of left shoulder girdle, sequela
Billing statusBillableBillable
ClassificationS00-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)
DefinitionDislocation of other parts of left shoulder girdle, initial encounter is a billable ICD-10-CM diagnosis code (S43.395A).Dislocation of other parts of left shoulder girdle, sequela is a billable ICD-10-CM diagnosis code (S43.395S).
7th characterThe appropriate 7th character is to be added to each code from category S43The appropriate 7th character is to be added to each code from category S43
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
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