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S43.90XA vs S46

S43.90XA (Sprain of unspecified parts of unspecified shoulder girdle, initial encounter) compared with S46 (Injury of muscle, fascia and tendon at shoulder and upper arm level), 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. S43.90XA carries an Excludes2 note covering S46: “strain of muscle, fascia and tendon of shoulder and upper arm (S46.-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Yes, when both are documented. S46 carries an Excludes2 note covering S43.90XA: “sprain of joints and ligaments of shoulder girdle (S43.9)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

S43.90XASprain of unspecified parts of unspecified shoulder girdle, initial encounterS46Injury of muscle, fascia and tendon at shoulder and upper arm level
Billing statusBillableNon-billable header

Report instead: S46.001A, S46.001D, S46.001S, S46.002A, S46.002D

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)
DefinitionSprain of unspecified parts of unspecified shoulder girdle, initial encounter is a billable ICD-10-CM diagnosis code (S43.90A).Injury of muscle, fascia and tendon at shoulder and upper arm level is a non-billable ICD-10-CM category code (S46).
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 S46
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
injuries of axilla
injuries of scapular region

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources