S49.90XD vs S59
S49.90XD (Unspecified injury of shoulder and upper arm, unspecified arm, subsequent encounter) compared with S59 (Other and unspecified injuries 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. S49.90XD carries an Excludes2 note covering S59: “injuries of elbow (S50-S59)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| S49.90XDUnspecified injury of shoulder and upper arm, unspecified arm, subsequent encounter | S59Other and unspecified injuries of elbow and forearm | |
|---|---|---|
| Billing status | Billable | Non-billable header Report instead: S59.001A, S59.001D, S59.001G, S59.001K, S59.001P |
| 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 | Unspecified injury of shoulder and upper arm, unspecified arm, subsequent encounter is a billable ICD-10-CM diagnosis code (S49.90D). | Other and unspecified injuries of elbow and forearm is a non-billable ICD-10-CM category code (S59). |
| 7th character | The appropriate 7th character is to be added to each code in subcategory S49.9 | The appropriate 7th character is to be added to each code from subcategories S59.0, S59.1, and S59.2 |
| Includes | 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