S43.60XA ICD-10-CM Code: Sprain of unspecified sternoclavicular joint, initial encounter
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)
- MS-DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)
- MS-DRG 964 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC (MDC 24)
- MS-DRG 965 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC (MDC 24)
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
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for S43.60XA in the official ICD-10-CM tabular list.
Includes
Conditions the official ICD-10-CM tabular list includes under this code.
- avulsion of joint or ligament of shoulder girdle
- laceration of cartilage, joint or ligament of shoulder girdle
- sprain of cartilage, joint or ligament of shoulder girdle
- traumatic hemarthrosis of joint or ligament of shoulder girdle
- traumatic rupture of joint or ligament of shoulder girdle
- traumatic subluxation of joint or ligament of shoulder girdle
- traumatic tear of joint or ligament of shoulder girdle
- injuries of axilla
- injuries of scapular region
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- strain of muscle, fascia and tendon of shoulder and upper arm (S46.-) Compare S43.60XA vs S46 →
- burns and corrosions (T20-T32) Compare S43.60XA vs T20 →
- frostbite (T33-T34) Compare S43.60XA vs T33 →
- injuries of elbow (S50-S59) Compare S43.60XA vs S50 →
- insect bite or sting, venomous (T63.4) Compare S43.60XA vs T63.4 →
Code Also
Additional codes that may be required to fully describe the encounter.
- any associated open wound
Change history
No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.
Verify Before Coding
- Billable — reportable as written.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.
Contextual Map
Every relationship of S43.60XA 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
- S43.60 — Sprain of unspecified sternoclavicular joint [Hierarchy]
Clinical classification (CCSR)
- INJ024 — Sprains and strains, initial encounter [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)”
- DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)”
- DRG 964 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC (MDC 24)”
- DRG 965 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC (MDC 24)”
Nearest codes (40)
- S43 — Dislocation and sprain of joints and ligaments of shoulder girdle [Sibling]
- S43.492S — Other sprain of left shoulder joint, sequela [Sibling]
- S43.499 — Other sprain of unspecified shoulder joint [Sibling]
- S43.499A — Other sprain of unspecified shoulder joint, initial encounter [Sibling]
- S43.499D — Other sprain of unspecified shoulder joint, subsequent encounter [Sibling]
- S43.499S — Other sprain of unspecified shoulder joint, sequela [Sibling]
- S43.5 — Sprain of acromioclavicular joint [Sibling]
- S43.50 — Sprain of unspecified acromioclavicular joint [Sibling]
- and 32 more
Relationships & Classification
Clinical classification (AHRQ CCSR):INJ024 — Sprains and strains, initial encounter (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
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 5 MS-DRGs: DRG 562 (MDC 08), DRG 563 (MDC 08), DRG 963 (MDC 24), DRG 964 (MDC 24), DRG 965 (MDC 24).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Frequently Asked Questions (FAQ) & Clinical Guidance
Does S43.60XA require a 7th character?
Yes. The appropriate 7th character is to be added to each code from category S43.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to S43.60XA in its code family, with their registry titles.
- S43.52XA — Sprain of left acromioclavicular joint, initial encounter
- S43.52XD — Sprain of left acromioclavicular joint, subsequent encounter
- S43.52XS — Sprain of left acromioclavicular joint, sequela
- S43.6 — Sprain of sternoclavicular joint
- S43.60 — Sprain of unspecified sternoclavicular joint
- S43.60XD — Sprain of unspecified sternoclavicular joint, subsequent encounter
- S43.60XS — Sprain of unspecified sternoclavicular joint, sequela
- S43.61 — Sprain of right sternoclavicular joint
- S43.61XA — Sprain of right sternoclavicular joint, initial encounter
- S43.61XD — Sprain of right sternoclavicular joint, subsequent encounter