S43.80XS ICD-10-CM Code: Sprain of other specified parts of unspecified shoulder girdle, 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
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for S43.80XS 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 S43.80XS vs S46 →
- burns and corrosions (T20-T32) Compare S43.80XS vs T20 →
- frostbite (T33-T34) Compare S43.80XS vs T33 →
- injuries of elbow (S50-S59) Compare S43.80XS vs S50 →
- insect bite or sting, venomous (T63.4) Compare S43.80XS vs T63.4 →
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 S43.80XS 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.
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).
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 S43.80XS 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)
- INJ073 — Injury, sequela [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)
- S43 — Dislocation and sprain of joints and ligaments of shoulder girdle [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]
- S43.60XD — Sprain of unspecified sternoclavicular joint, subsequent encounter [Sibling]
- and 32 more
Frequently Asked Questions (FAQ) & Clinical Guidance
Does S43.80XS 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 S43.80XS in its code family, with their registry titles.
- 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
- S43.80XD — Sprain of other specified parts of unspecified shoulder girdle, subsequent encounter
- 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
- S43.82 — Sprain of other specified parts of left shoulder girdle