S46.812A vs S46.812S

S46.812A (Strain of other muscles, fascia and tendons at shoulder and upper arm level, left arm, initial encounter) compared with S46.812S (Strain of other muscles, fascia and tendons at shoulder and upper arm level, left arm, sequela), from the official CMS tabular data. S46.812A and S46.812S code the same injury at a different phase of treatment. MedCoder-derived

Relationship

Review

Encounter relationship

S46.812A

Initial encounter

Strain of other muscles, fascia and tendons at shoulder and upper arm level, left arm, initial encounter

↔

S46.812S

Sequela

Strain of other muscles, fascia and tendons at shoulder and upper arm level, left arm, sequela

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

Can these codes be reported together?

Same injury, other encounter phase. S46.812A and S46.812S 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

	S46.812AStrain of other muscles, fascia and tendons at shoulder and upper arm level, left arm, initial encounter	S46.812SStrain of other muscles, fascia and tendons at shoulder and upper arm level, left arm, sequela
Billing status	Billable	Billable
Classification	S00-T88 — Injury, poisoning and certain other consequences of external causes	S00-T88 — Injury, poisoning and certain other consequences of external causes
Definition	Strain of other muscles, fascia and tendons at shoulder and upper arm level, left arm, initial encounter is a billable ICD-10-CM diagnosis code (S46.812A).	Strain of other muscles, fascia and tendons at shoulder and upper arm level, left arm, sequela is a billable ICD-10-CM diagnosis code (S46.812S).
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

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