S49.80XA vs S49.80XD

S49.80XA (Other specified injuries of shoulder and upper arm, unspecified arm, initial encounter) compared with S49.80XD (Other specified injuries of shoulder and upper arm, unspecified arm, subsequent encounter), from the official CMS tabular data. S49.80XA and S49.80XD code the same injury at a different phase of treatment.

Relationship

Review

Encounter relationship

S49.80XA

Initial encounter

Other specified injuries of shoulder and upper arm, unspecified arm, initial encounter

↔

S49.80XD

Subsequent encounter

Other specified injuries of shoulder and upper arm, unspecified arm, subsequent encounter

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. S49.80XA and S49.80XD 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

	S49.80XAOther specified injuries of shoulder and upper arm, unspecified arm, initial encounter	S49.80XDOther specified injuries of shoulder and upper arm, unspecified arm, subsequent encounter
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	Other specified injuries of shoulder and upper arm, unspecified arm, initial encounter is a billable ICD-10-CM diagnosis code (S49.80A).	Other specified injuries of shoulder and upper arm, unspecified arm, subsequent encounter is a billable ICD-10-CM diagnosis code (S49.80D).
7th character	The appropriate 7th character is to be added to each code in subcategory S49.8	The appropriate 7th character is to be added to each code in subcategory S49.8
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