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S46.091 vs S46.099

S46.091 (Other injury of muscle(s) and tendon(s) of the rotator cuff of right shoulder) compared with S46.099 (Other injury of muscle(s) and tendon(s) of the rotator cuff of unspecified shoulder), from the official CMS tabular data. S46.091 and S46.099 code the same condition on opposite sides. MedCoder-derived

Relationship

Review

Laterality relationship

S46.091
Right
Other injury of muscle(s) and tendon(s) of the rotator cuff of right shoulder
S46.099
Unspecified
Other injury of muscle(s) and tendon(s) of the rotator cuff of unspecified shoulder

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)

Can these codes be reported together?

Same condition, opposite side. S46.091 and S46.099 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.

Side by side

S46.091Other injury of muscle(s) and tendon(s) of the rotator cuff of right shoulderS46.099Other injury of muscle(s) and tendon(s) of the rotator cuff of unspecified shoulder
Billing statusNon-billable header

Report instead: S46.091A, S46.091D, S46.091S

Non-billable header

Report instead: S46.099A, S46.099D, S46.099S

ClassificationS00-T88 — Injury, poisoning and certain other consequences of external causesS00-T88 — Injury, poisoning and certain other consequences of external causes
DefinitionOther injury of muscle(s) and tendon(s) of the rotator cuff of right shoulder is a non-billable ICD-10-CM category code (S46.091).Other injury of muscle(s) and tendon(s) of the rotator cuff of unspecified shoulder is a non-billable ICD-10-CM category code (S46.099).
7th characterThe appropriate 7th character is to be added to each code from category S46The 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