S43.422D — Sprain of left rotator cuff capsule, subsequent encounter
Is S43.422D billable?
Yes — S43.422D is billable for FY2027. S43.422D is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. S43.422D may be submitted for encounters from October 1, 2026 through September 30, 2027.
S43.422D at a glance
| Code | S43.422D |
|---|---|
| Description | Sprain of left rotator cuff capsule, subsequent encounter |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "D" | subsequent encounter |
What does the 7th character "D" mean in S43.422D?
In S43.422D, the 7th character D means subsequent encounter. The 7th character is required for S43.422D to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does S43.422D group to?
S43.422D sits in MDC 23 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 949Aftercare with CC/MCCmedical
- 950Aftercare without CC/MCCmedical
How is S43.422D listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S43.42, the nearest indexed parent of S43.422D. Use them to find the family, then select the specific code.
- Sprain › rotator cuff (joint) (ligament)
- Tear, torn › rotator cuff › traumatic › capsule (traumatic)
Excludes1 — never code together — inherited from S43.42
The conditions below can never be reported together with S43.422D on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- rotator cuff syndrome (complete) (incomplete), not specified as traumatic (M75.1-)
Use additional code — inherited from Chapter 19
Report an additional code alongside S43.422D to fully describe the condition. S43.422D 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 S43.422D, but a patient may have both at the same time. When documentation supports it, S43.422D and the excluded code may both be reported.
Excludes2 — not included here — inherited from S40-S49
The conditions below are not part of S43.422D, but a patient may have both at the same time. When documentation supports it, S43.422D and the excluded code may both be reported.
Excludes2 — not included here — inherited from S43
The conditions below are not part of S43.422D, but a patient may have both at the same time. When documentation supports it, S43.422D and the excluded code may both be reported.
- strain of muscle, fascia and tendon of shoulder and upper arm (S46.-)
Excludes2 — not included here — inherited from S43.42
The conditions below are not part of S43.422D, but a patient may have both at the same time. When documentation supports it, S43.422D and the excluded code may both be reported.
- injury of tendon of rotator cuff (S46.0-)
Code also — inherited from S43
Two codes may be needed to describe the condition fully. Whether S43.422D is sequenced first depends on the reason for the encounter.
- any associated open wound
How long has S43.422D existed?
S43.422D 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.