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S03.43XS ICD-10-CM Code: Sprain of jaw, bilateral, sequela

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 562 — FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC (MDC 08)
  • MS-DRG 563 — FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC (MDC 08)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Official Registry Overview & Definition

Sprain of jaw, bilateral, sequela is a billable ICD-10-CM diagnosis code (S03.43S).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S03.43XS in the official ICD-10-CM tabular list.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • avulsion of joint (capsule) or ligament of head
  • laceration of cartilage, joint (capsule) or ligament of head
  • sprain of cartilage, joint (capsule) or ligament of head
  • traumatic hemarthrosis of joint or ligament of head
  • traumatic rupture of joint or ligament of head
  • traumatic subluxation of joint or ligament of head
  • traumatic tear of joint or ligament of head
  • injuries of ear
  • injuries of eye
  • injuries of face [any part]
  • injuries of gum
  • injuries of jaw
  • injuries of oral cavity
  • injuries of palate
  • injuries of periocular area
  • injuries of scalp
  • injuries of temporomandibular joint area
  • injuries of tongue
  • injuries of tooth

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code Also

Additional codes that may be required to fully describe the encounter.

  • any associated open wound
  • for any associated infection

Frequently Compared Codes

The official Excludes notes on S03.43XS name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Sprain of jaw, bilateral, sequela
    FY2017 changes

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Relationships & Classification

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 2 MS-DRGs: DRG 562 (MDC 08), DRG 563 (MDC 08).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):INJ073 — Injury, sequela (default); DEN001 — Any dental condition including traumatic injury.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Contextual Map

Every relationship of S03.43XS in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88) [Hierarchy]
  • S00-S09 — Injuries to the head [Hierarchy]

Clinical classification (CCSR)

  • INJ073 — Injury, sequela [CCSR]
  • DEN001 — Any dental condition including traumatic injury [CCSR]

Potential MS-DRG

  • DRG 562 — FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC [MS-DRG]: “FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC (MDC 08)”
  • DRG 563 — FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC [MS-DRG]: “FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC (MDC 08)”

MDC crossing · procedures (18508)

  • MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue [MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 005T0ZZ — Destruction of Spinal Meninges, Open Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T3ZZ — Destruction of Spinal Meninges, Percutaneous Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T4ZZ — Destruction of Spinal Meninges, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Endoscopic Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0Z3 — Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0ZZ — Destruction of Cervical Spinal Cord, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • and 18503 more

Nearest codes (40)

  • S03 — Dislocation and sprain of joints and ligaments of head [Sibling]
  • S03.02 — Dislocation of jaw, left side [Sibling]
  • S03.02XA — Dislocation of jaw, left side, initial encounter [Sibling]
  • S03.02XD — Dislocation of jaw, left side, subsequent encounter [Sibling]
  • S03.02XS — Dislocation of jaw, left side, sequela [Sibling]
  • S03.03 — Dislocation of jaw, bilateral [Sibling]
  • S03.03XA — Dislocation of jaw, bilateral, initial encounter [Sibling]
  • S03.03XD — Dislocation of jaw, bilateral, subsequent encounter [Sibling]
  • and 32 more

Change history

  • FY2017 — Added to the code set [Change history]

Frequently Asked Questions (FAQ) & Clinical Guidance

Does S03.43XS require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category S03.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to S03.43XS in its code family, with their registry titles.

  • S03.42XD — Sprain of jaw, left side, subsequent encounter
  • S03.42XS — Sprain of jaw, left side, sequela
  • S03.43 — Sprain of jaw, bilateral
  • S03.43XA — Sprain of jaw, bilateral, initial encounter
  • S03.43XD — Sprain of jaw, bilateral, subsequent encounter
  • S03.8 — Sprain of joints and ligaments of other parts of head
  • S03.8XXA — Sprain of joints and ligaments of other parts of head, initial encounter
  • S03.8XXD — Sprain of joints and ligaments of other parts of head, subsequent encounter
  • S03.8XXS — Sprain of joints and ligaments of other parts of head, sequela
  • S03.9 — Sprain of joints and ligaments of unspecified parts of head

View all codes in the S03 family