S43.491 (Other sprain of right shoulder joint) compared with S43.492 (Other sprain of left shoulder joint), from the official CMS tabular data. S43.491 and S43.492 code the same condition on opposite sides. MedCoder-derived
Same condition; these differ only in which side is documented.
These codes share a category and title and differ only in the side affected. The documentation decides which applies, and a bilateral code is reported only where the code set provides one.
Source: ICD-10-CM tabular list (laterality variant derived from the code title)
Same condition, opposite side. S43.491 and S43.492 name the same condition on opposite sides of the body.
Same category and title, differing only in which side is affected — the documentation decides which one applies, and a bilateral code is reported only where the code set provides one.
| S43.491Other sprain of right shoulder joint | S43.492Other sprain of left shoulder joint | |
|---|---|---|
| Billing status | Non-billable header | Non-billable header |
| Classification | S00-T88 — Injury, poisoning and certain other consequences of external causes | S00-T88 — Injury, poisoning and certain other consequences of external causes |
| Definition | Other sprain of right shoulder joint is a non-billable ICD-10-CM category code (S43.491). | Other sprain of left shoulder joint is a non-billable ICD-10-CM category code (S43.492). |
| 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 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