Skip to main content

S43.80XD ICD-10-CM Code: Sprain of other specified parts of unspecified shoulder girdle, subsequent 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.

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 other specified parts of unspecified shoulder girdle, subsequent encounter is a billable ICD-10-CM diagnosis code (S43.80D).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S43.80XD 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.

Code Also

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

  • any associated open wound

Frequently Compared Codes

The official Excludes notes on S43.80XD name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.

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.

Contextual Map

Every relationship of S43.80XD 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]
  • S40-S49 — Injuries to the shoulder and upper arm [Hierarchy]

Clinical classification (CCSR)

  • INJ061 — Sprains and strains, subsequent encounter [CCSR]

Potential MS-DRG

  • DRG 949 — AFTERCARE WITH CC/MCC [MS-DRG]: “AFTERCARE WITH CC/MCC (MDC 23)”
  • DRG 950 — AFTERCARE WITHOUT CC/MCC [MS-DRG]: “AFTERCARE WITHOUT CC/MCC (MDC 23)”

MDC crossing · procedures (1235)

  • MDC 23 — Factors Influencing Health Status and Other Contacts with Health Services [MDC crossing]: “Factors Influencing Health Status and Other Contacts with Health Services — 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.”
  • F003GKZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Audiovisual Equipment [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Audiovisual Equipment — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GMZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Augmentative / Alternative Communication Equipment [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Augmentative / Alternative Communication Equipment — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GPZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Computer [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Computer — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GYZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Other Equipment [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Other Equipment — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GZZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • and 1230 more

Nearest codes (40)

  • S43 — Dislocation and sprain of joints and ligaments of shoulder girdle [Sibling]
  • S43.52 — Sprain of left acromioclavicular joint [Sibling]
  • S43.52XA — Sprain of left acromioclavicular joint, initial encounter [Sibling]
  • S43.52XD — Sprain of left acromioclavicular joint, subsequent encounter [Sibling]
  • S43.52XS — Sprain of left acromioclavicular joint, sequela [Sibling]
  • S43.6 — Sprain of sternoclavicular joint [Sibling]
  • S43.60 — Sprain of unspecified sternoclavicular joint [Sibling]
  • S43.60XA — Sprain of unspecified sternoclavicular joint, initial encounter [Sibling]
  • and 32 more

Relationships & Classification

Clinical classification (AHRQ CCSR):INJ061 — Sprains and strains, subsequent 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 2 MS-DRGs: DRG 949 (MDC 23), DRG 950 (MDC 23).

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 S43.80XD 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 S43.80XD in its code family, with their registry titles.

  • S43.62XD — Sprain of left sternoclavicular joint, subsequent encounter
  • S43.62XS — Sprain of left sternoclavicular joint, sequela
  • S43.8 — Sprain of other specified parts of shoulder girdle
  • S43.80 — Sprain of other specified parts of unspecified shoulder girdle
  • S43.80XA — Sprain of other specified parts of unspecified shoulder girdle, initial encounter
  • S43.80XS — Sprain of other specified parts of unspecified shoulder girdle, sequela
  • S43.81 — Sprain of other specified parts of right shoulder girdle
  • S43.81XA — Sprain of other specified parts of right shoulder girdle, initial encounter
  • S43.81XD — Sprain of other specified parts of right shoulder girdle, subsequent encounter
  • S43.81XS — Sprain of other specified parts of right shoulder girdle, sequela

View all codes in the S43 family