S43.90XA vs S43.90XS
S43.90XA (Sprain of unspecified parts of unspecified shoulder girdle, initial encounter) compared with S43.90XS (Sprain of unspecified parts of unspecified shoulder girdle, sequela), from the official CMS tabular data. S43.90XA and S43.90XS code the same injury at a different phase of treatment.
Can these codes be reported together?
Same injury, other encounter phase. S43.90XA and S43.90XS 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
| S43.90XASprain of unspecified parts of unspecified shoulder girdle, initial encounter | S43.90XSSprain of unspecified parts of unspecified shoulder girdle, sequela | |
|---|---|---|
| Billing status | Billable | Billable |
| 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 | Sprain of unspecified parts of unspecified shoulder girdle, initial encounter is a billable ICD-10-CM diagnosis code (S43.90A). | Sprain of unspecified parts of unspecified shoulder girdle, sequela is a billable ICD-10-CM diagnosis code (S43.90S). |
| 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