S43.4 — Sprain of shoulder joint
Is S43.4 billable?
No — S43.4 is a non-billable header code. S43.4 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 45 billable codes beneath S43.4.
Billable codes under this header
- S43.401AUnspecified sprain of right shoulder joint, initial encounter
- S43.401DUnspecified sprain of right shoulder joint, subsequent encounter
- S43.401SUnspecified sprain of right shoulder joint, sequela
- S43.402AUnspecified sprain of left shoulder joint, initial encounter
- S43.402DUnspecified sprain of left shoulder joint, subsequent encounter
- S43.402SUnspecified sprain of left shoulder joint, sequela
- S43.409AUnspecified sprain of unspecified shoulder joint, initial encounter
- S43.409DUnspecified sprain of unspecified shoulder joint, subsequent encounter
- S43.409SUnspecified sprain of unspecified shoulder joint, sequela
- S43.411ASprain of right coracohumeral (ligament), initial encounter
- S43.411DSprain of right coracohumeral (ligament), subsequent encounter
- S43.411SSprain of right coracohumeral (ligament), sequela
- S43.412ASprain of left coracohumeral (ligament), initial encounter
- S43.412DSprain of left coracohumeral (ligament), subsequent encounter
- S43.412SSprain of left coracohumeral (ligament), sequela
- S43.419ASprain of unspecified coracohumeral (ligament), initial encounter
- S43.419DSprain of unspecified coracohumeral (ligament), subsequent encounter
- S43.419SSprain of unspecified coracohumeral (ligament), sequela
- S43.421ASprain of right rotator cuff capsule, initial encounter
- S43.421DSprain of right rotator cuff capsule, subsequent encounter
- S43.421SSprain of right rotator cuff capsule, sequela
- S43.422ASprain of left rotator cuff capsule, initial encounter
- S43.422DSprain of left rotator cuff capsule, subsequent encounter
- S43.422SSprain of left rotator cuff capsule, sequela
- S43.429ASprain of unspecified rotator cuff capsule, initial encounter
- S43.429DSprain of unspecified rotator cuff capsule, subsequent encounter
- S43.429SSprain of unspecified rotator cuff capsule, sequela
- S43.431ASuperior glenoid labrum lesion of right shoulder, initial encounter
- S43.431DSuperior glenoid labrum lesion of right shoulder, subsequent encounter
- S43.431SSuperior glenoid labrum lesion of right shoulder, sequela
- S43.432ASuperior glenoid labrum lesion of left shoulder, initial encounter
- S43.432DSuperior glenoid labrum lesion of left shoulder, subsequent encounter
- S43.432SSuperior glenoid labrum lesion of left shoulder, sequela
- S43.439ASuperior glenoid labrum lesion of unspecified shoulder, initial encounter
- S43.439DSuperior glenoid labrum lesion of unspecified shoulder, subsequent encounter
- S43.439SSuperior glenoid labrum lesion of unspecified shoulder, sequela
- S43.491AOther sprain of right shoulder joint, initial encounter
- S43.491DOther sprain of right shoulder joint, subsequent encounter
- S43.491SOther sprain of right shoulder joint, sequela
- S43.492AOther sprain of left shoulder joint, initial encounter
- S43.492DOther sprain of left shoulder joint, subsequent encounter
- S43.492SOther sprain of left shoulder joint, sequela
- S43.499AOther sprain of unspecified shoulder joint, initial encounter
- S43.499DOther sprain of unspecified shoulder joint, subsequent encounter
- S43.499SOther sprain of unspecified shoulder joint, sequela
S43.4 at a glance
| Code | S43.4 |
|---|---|
| Description | Sprain of shoulder joint |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Use additional code — inherited from Chapter 19
Report an additional code alongside S43.4 to fully describe the condition. S43.4 is sequenced first.
- code to identify any retained foreign body, if applicable (Z18.-)
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of S43.4, but a patient may have both at the same time. When documentation supports it, S43.4 and the excluded code may both be reported.
Excludes2 — not included here — inherited from S40-S49
The conditions below are not part of S43.4, but a patient may have both at the same time. When documentation supports it, S43.4 and the excluded code may both be reported.
Excludes2 — not included here — inherited from S43
The conditions below are not part of S43.4, but a patient may have both at the same time. When documentation supports it, S43.4 and the excluded code may both be reported.
- strain of muscle, fascia and tendon of shoulder and upper arm (S46.-)
Code also — inherited from S43
Two codes may be needed to describe the condition fully. Whether S43.4 is sequenced first depends on the reason for the encounter.
- any associated open wound
What codes fall under S43.4? (5)
How long has S43.4 existed?
S43.4 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
What other codes are in the S43 family? (8)
- S43.0Subluxation and dislocation of shoulder jointnot billable
- S43.1Subluxation and dislocation of acromioclavicular jointnot billable
- S43.2Subluxation and dislocation of sternoclavicular jointnot billable
- S43.3Subluxation and dislocation of other and unspecified parts of shoulder girdlenot billable
- S43.5Sprain of acromioclavicular jointnot billable
- S43.6Sprain of sternoclavicular jointnot billable
- S43.8Sprain of other specified parts of shoulder girdlenot billable
- S43.9Sprain of unspecified parts of shoulder girdlenot billable