S46.999A — Other injury of unspecified muscle, fascia and tendon at shoulder and upper arm level, unspecified arm, initial encounter
Is S46.999A billable?
Yes, but S46.999A is an unspecified code. S46.999A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, S46.999A is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting S46.999A — the more specific alternatives are listed below.
More specific alternatives
- S46.001AUnspecified injury of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter
- S46.101AUnspecified injury of muscle, fascia and tendon of long head of biceps, right arm, initial encounter
- S46.201AUnspecified injury of muscle, fascia and tendon of other parts of biceps, right arm, initial encounter
- S46.301AUnspecified injury of muscle, fascia and tendon of triceps, right arm, initial encounter
- S46.801AUnspecified injury of other muscles, fascia and tendons at shoulder and upper arm level, right arm, initial encounter
S46.999A at a glance
| Code | S46.999A |
|---|---|
| Description | Other injury of unspecified muscle, fascia and tendon at shoulder and upper arm level, unspecified arm, initial encounter |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter |
What does the 7th character "A" mean in S46.999A?
In S46.999A, the 7th character A means initial encounter. The 7th character is required for S46.999A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does S46.999A group to?
S46.999A sits in MDC 21 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.
- 913Traumatic Injury with MCCmedical
- 914Traumatic Injury without MCCmedical
How is S46.999A listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S46.99, the nearest indexed parent of S46.999A. Use them to find the family, then select the specific code.
- Injury › muscle › shoulder › specified type NEC
Use additional code — inherited from Chapter 19
Report an additional code alongside S46.999A to fully describe the condition. S46.999A 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 S46.999A, but a patient may have both at the same time. When documentation supports it, S46.999A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S40-S49
The conditions below are not part of S46.999A, but a patient may have both at the same time. When documentation supports it, S46.999A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S46
The conditions below are not part of S46.999A, but a patient may have both at the same time. When documentation supports it, S46.999A and the excluded code may both be reported.
Code also — inherited from S46
Two codes may be needed to describe the condition fully. Whether S46.999A is sequenced first depends on the reason for the encounter.
- any associated open wound (S41.-)
How long has S46.999A existed?
S46.999A 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.