S46.011A (Strain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter) compared with S46.011S (Strain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, sequela), from the official CMS tabular data. S46.011A and S46.011S code the same injury at a different phase of treatment.
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
Same injury, other encounter phase. S46.011A and S46.011S 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.
| S46.011AStrain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter | S46.011SStrain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, 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 | Strain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter is a billable ICD-10-CM diagnosis code (S46.011A). | Strain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, sequela is a billable ICD-10-CM diagnosis code (S46.011S). |
| 7th character | The appropriate 7th character is to be added to each code from category S46 | The appropriate 7th character is to be added to each code from category S46 |
| Includes | injuries of axilla injuries of scapular region | 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