S43.90XA vs S50
S43.90XA (Sprain of unspecified parts of unspecified shoulder girdle, initial encounter) compared with S50 (Superficial injury of elbow and forearm), 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 S50: “injuries of elbow (S50-S59)”
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 encounter | S50Superficial injury of elbow and forearm | |
|---|---|---|
| Billing status | Billable | Non-billable header Report instead: S50.00XA, S50.00XD, S50.00XS, S50.01XA, S50.01XD |
| 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). | Superficial injury of elbow and forearm is a non-billable ICD-10-CM category code (S50). |
| 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 S50 |
| 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 | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources