Skip to main content

S33.6 ICD-10-CM Code: Sprain of sacroiliac joint

Compare with another code for S33.6Check this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

7th character
Required — see the character table on this page
Tabular directives
13 inclusion terms · 2 Excludes1 · 8 Excludes2 · 1 code-also instruction

Not billable · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

7th character:required: report a code with a 7th character· The appropriate 7th character is to be added to each code from category S33See the 7th character note

Excludes1from S33Not reported with this code unless documented as unrelated
  • nontraumatic rupture or displacement of lumbar intervertebral disc NOS (M51.-)
  • obstetric damage to pelvic joints and ligaments (O71.6)
Code alsofrom S33May be needed with this code
  • any associated open wound
Excludes2Not included here; may be reported together
  • dislocation and sprain of joints and ligaments of hip (S73.-) (from S33)
  • strain of muscle of lower back and pelvis (S39.01-) (from S33)
  • burns and corrosions (T20-T32) (from S30-S39)
  • effects of foreign body in anus and rectum (T18.5) (from S30-S39)

+4 more in Instructions

IncludesWhat this code covers
  • avulsion of joint or ligament of lumbar spine and pelvis (from S33)
  • laceration of cartilage, joint or ligament of lumbar spine and pelvis (from S33)
  • sprain of cartilage, joint or ligament of lumbar spine and pelvis (from S33)
  • traumatic hemarthrosis of joint or ligament of lumbar spine and pelvis (from S33)

+9 more in Instructions

Where it sits Source: CMS/NCHS

Under:Chapter 19: Injury, Poisoning and Certain Other Consequences of External CausesS30-S39 Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitalsS33 Dislocation and sprain of joints and ligaments of lumbar spine and pelvis

Codes under S33.6 (3)

  • S33.6XXASprain of sacroiliac joint, initial encounterBillable
  • S33.6XXDSprain of sacroiliac joint, subsequent encounterBillable
  • S33.6XXSSprain of sacroiliac joint, sequelaBillable

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for S33.6 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on S33.6 itself; “inherited from” names the category or block whose note applies here.

Includes

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

  • avulsion of joint or ligament of lumbar spine and pelvis inherited from S33
  • laceration of cartilage, joint or ligament of lumbar spine and pelvis inherited from S33
  • sprain of cartilage, joint or ligament of lumbar spine and pelvis inherited from S33
  • traumatic hemarthrosis of joint or ligament of lumbar spine and pelvis inherited from S33
  • traumatic rupture of joint or ligament of lumbar spine and pelvis inherited from S33
  • traumatic subluxation of joint or ligament of lumbar spine and pelvis inherited from S33
  • traumatic tear of joint or ligament of lumbar spine and pelvis inherited from S33
  • injuries to the abdominal wall inherited from S30-S39
  • injuries to the anus inherited from S30-S39
  • injuries to the buttock inherited from S30-S39
  • injuries to the external genitalia inherited from S30-S39
  • injuries to the flank inherited from S30-S39
  • injuries to the groin inherited from S30-S39

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from S33

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

Source: inherited from S33

7th Character Guide

"The appropriate 7th character is to be added to each code from category S33"

  • A — initial encounter
  • D — subsequent encounter
  • S — sequela

How the encounter character is assigned. “Initial encounter” means the patient is receiving active treatment for the condition — it is not limited to the first visit, and a different or new provider giving active treatment still assigns it. “Subsequent encounter” covers care during the healing or recovery phase after active treatment. “Sequela” is for complications or conditions that arise as a direct result of the original condition.

ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.19.a (paraphrased by MedCoder).

Variant codes in this family

S33.6XXA, S33.6XXD, S33.6XXS

Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.

Coder workflow for S33.6

MedCoder structured workflow — derived from this code’s own official record

Before you code S33.6

  1. S33.6 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewS33.6XXA, S33.6XXD, S33.6XXS

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. A 7th character is required in this family. Confirm the documented encounter: initial (active treatment), subsequent (healing or recovery phase), or sequela. S33.6 is not valid without one. “Initial” means active treatment, not the first visit (Guidelines I.C.19.a).

    See the 7th Character Guide · Guide: 7th characters: initial, subsequent, sequela →

  3. Confirm the injury type, the anatomical site at the most specific level documented, laterality where the family codes it, and the encounter for the 7th character. Each injury is coded separately unless the classification provides a combination code, and a superficial injury is not coded when a more severe injury of the same site is documented. Injury chapter guidelines (Guidelines I.C.19.b, I.C.19.b.1).

    Guide: 7th characters: initial, subsequent, sequela →

  4. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with the code beneath S33.6. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath S33.6?
    Yes → Select that code and continue the checks below on its own page.
    No → S33.6 cannot be reported as written. Where the codes beneath it include an unspecified code, that code applies when the record goes no further; otherwise query for the missing detail.

    ReviewS33.6XXA, S33.6XXD, S33.6XXS

  2. Does the documentation support a condition named in S33.6’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewM51, O71.6

  3. Is the encounter phase documented — active treatment, healing or recovery, or a sequela?
    Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
    No → The code is invalid without its 7th character — query for the missing element.

Report the code beneath S33.6 that the documentation supports, not S33.6 itself. Then review the Code Also note, and confirm that code is valid for the date of service on its own page.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Anatomical site
At the most specific level the record states; a site the classification separates cannot be assumed from a procedure or a measurement.
Encounter type
Active treatment, healing or recovery phase, or sequela — the basis of the 7th character (Guidelines I.C.19.a).
External cause, place and activity
For the external cause codes reported with the injury or poisoning, where documented (Guidelines I.C.20.a).

Official instructions as workflow

  • Excludes1 — check before selecting S33.6(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with S33.6: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareM51, O71.6

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of S33.6(8 notes)

    Coding workflow: The conditions named in this note are not included in S33.6. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareS73, S39.01, T18.5, T19, T63.4

    See the official tabular notes · Guidelines I.A.12.b

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition S33.6 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewM51, O71.6

Documentation: The patient returns during the healing or recovery phase after active treatment of the same condition.

Coding question: Which 7th character applies?

Path: Review the official 7th-character definitions for this family in the 7th Character Guide.

Reason: “Initial encounter” means active treatment, not the first visit; care during recovery takes “subsequent encounter”, and a complication arising from the original condition takes “sequela” (Guidelines I.C.19.a).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse S33.6 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of S33.6 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • M51— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of nontraumatic rupture or displacement of lumbar intervertebral disc NOS moves the case to M51; the two are not reported together unless documented as unrelated.

    Full comparison: S33.6 vs M51 →

  • O71.6— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of obstetric damage to pelvic joints and ligaments moves the case to O71.6; the two are not reported together unless documented as unrelated.

    Full comparison: S33.6 vs O71.6 →

  • S33.3— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Dislocation of other and unspecified parts of lumbar spine and pelvis” takes S33.3; specificity in the record moves it back here.

    Full comparison: S33.6 vs S33.3 →

  • S33.6XXA— Encounter relationship (Review)

    Same underlying diagnosis, different encounter phase.

    The same diagnosis at a different phase of care; one encounter takes one 7th character.

    What moves you there: Documentation of a initial encounter moves the case to S33.6XXA.

    Full comparison: S33.6 vs S33.6XXA →

  • S33.6XXD— Encounter relationship (Review)

    Same underlying diagnosis, different encounter phase.

    The same diagnosis at a different phase of care; one encounter takes one 7th character.

    What moves you there: Documentation of a subsequent encounter moves the case to S33.6XXD.

    Full comparison: S33.6 vs S33.6XXD →

  • S73— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of dislocation and sprain of joints and ligaments of hip adds S73; it is not part of this code and both may be reported when both are documented.

    Full comparison: S33.6 vs S73 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Sprain of sacroiliac joint is a non-billable ICD-10-CM category code (S33.6). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. A 7th character applies in this family. Confirm the documented encounter matches the character assigned. See the official 7th-character definitions and this code’s variants
  2. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  3. 2 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  4. 8 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

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

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name S33.6 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes2 note: S39 — Other and unspecified injuries of abdomen, lower back, pelvis and external genitals (via S33.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Related Codes

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Sprain”; these codes share that main term but sit in a different category of the Tabular List.

S13.5 — Sprain of thyroid region (neck, thyroid region), S13.8 — Sprain of joints and ligaments of other parts of neck (neck, specified site NEC), S13.9 — Sprain of joints and ligaments of unspecified parts of neck (neck), S23.3 — Sprain of ligaments of thoracic spine (dorsal), S23.41 — Sprain of ribs (rib), S23.421 — Sprain of chondrosternal joint (chondrosternal), S23.428 — Other sprain of sternum (sternum, specified site NEC), S23.429 — Unspecified sprain of sternum (sternum), S23.8 — Sprain of other specified parts of thorax (thorax, specified site NEC), S23.9 — Sprain of unspecified parts of thorax (thorax), S43.40 — Unspecified sprain of shoulder joint (shoulder joint), S43.41 — Sprain of coracohumeral (ligament) (coracohumeral), S43.42 — Sprain of rotator cuff capsule (rotator cuff), S43.49 — Other sprain of shoulder joint (shoulder joint, specified site NEC), S43.5 — Sprain of acromioclavicular joint (acromioclavicular joint or ligament), S43.6 — Sprain of sternoclavicular joint (sternoclavicular joint), S43.8 — Sprain of other specified parts of shoulder girdle (coracoclavicular), S43.9 — Sprain of unspecified parts of shoulder girdle (shoulder joint, girdle), S53.40 — Unspecified sprain of elbow (elbow), S53.41 — Radiohumeral (joint) sprain (elbow, radiohumeral), +48 more

Contextual Map

Every relationship of S33.6 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.

Run S33.6 with this related code in Claim Check

Hierarchy

Referenced by Excludes2 notes

Index entries

  • Sprain (joint) (ligament), innominate, sacral junction[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Sprain (joint) (ligament), sacroiliac (region), joint[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Common coding questions

MedCoder editorial

Can S33.6 be billed directly?

No. S33.6 (Sprain of sacroiliac joint) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Does S33.6 require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category S33.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "S33.6 — Sprain of sacroiliac joint." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/s33.6-sprain-of-sacroiliac-joint

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Sprain of sacroiliac joint

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to S33.6 in its code family, with their registry titles.

View all codes in the S33 family