S49.91 ICD-10-CM Code: Unspecified injury of right shoulder and upper arm
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for S49.91 in the official ICD-10-CM tabular list.
Includes
Conditions the official ICD-10-CM tabular list includes under this code.
- 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.
- burns and corrosions (T20-T32) Compare S49.91 vs T20 →
- frostbite (T33-T34) Compare S49.91 vs T33 →
- injuries of elbow (S50-S59) Compare S49.91 vs S50 →
- insect bite or sting, venomous (T63.4) Compare S49.91 vs T63.4 →
Change history
No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.
Verify Before Coding
- Not billable as written — a more specific code is required: S49.91XA, S49.91XD, S49.91XS.
- Requires a 7th character. "The appropriate 7th character is to be added to each code in subcategory S49.9" Options: S49.91XA, S49.91XD, S49.91XS
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 S49.91 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]
Nearest codes (40)
- S49 — Other and unspecified injuries of shoulder and upper arm [Sibling]
- S49.191S — Other physeal fracture of lower end of humerus, right arm, sequela [Sibling]
- S49.192 — Other physeal fracture of lower end of humerus, left arm [Sibling]
- S49.192A — Other physeal fracture of lower end of humerus, left arm, initial encounter for closed fracture [Sibling]
- S49.192D — Other physeal fracture of lower end of humerus, left arm, subsequent encounter for fracture with routine healing [Sibling]
- S49.192G — Other physeal fracture of lower end of humerus, left arm, subsequent encounter for fracture with delayed healing [Sibling]
- S49.192K — Other physeal fracture of lower end of humerus, left arm, subsequent encounter for fracture with nonunion [Sibling]
- S49.192P — Other physeal fracture of lower end of humerus, left arm, subsequent encounter for fracture with malunion [Sibling]
- and 32 more
Frequently Asked Questions (FAQ) & Clinical Guidance
Can S49.91 be billed directly?
No. S49.91 (Unspecified injury of right shoulder and upper arm) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
Does S49.91 require a 7th character?
Yes. The appropriate 7th character is to be added to each code in subcategory S49.9; The appropriate 7th character is to be added to each code from subcategories S49.0 and S49.1.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to S49.91 in its code family, with their registry titles.
- S49.9 — Unspecified injury of shoulder and upper arm
- S49.90 — Unspecified injury of shoulder and upper arm, unspecified arm
- S49.90XA — Unspecified injury of shoulder and upper arm, unspecified arm, initial encounter
- S49.90XD — Unspecified injury of shoulder and upper arm, unspecified arm, subsequent encounter
- S49.90XS — Unspecified injury of shoulder and upper arm, unspecified arm, sequela
- S49.91XA — Unspecified injury of right shoulder and upper arm, initial encounter
- S49.91XD — Unspecified injury of right shoulder and upper arm, subsequent encounter
- S49.91XS — Unspecified injury of right shoulder and upper arm, sequela
- S49.92 — Unspecified injury of left shoulder and upper arm
- S49.92XA — Unspecified injury of left shoulder and upper arm, initial encounter