2024 ICD-10-CM Diagnosis Code S43.216S

Anterior dislocation of unspecified sternoclavicular joint, sequela

ICD-10-CM Code:
S43.216S
ICD-10 Code for:
Anterior dislocation of unsp sternoclavicular joint, sequela
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

Code Classification

  • Injury, poisoning and certain other consequences of external causes
    (S00–T88)
    • Injuries to the shoulder and upper arm
      (S40-S49)
      • Dislocation and sprain of joints and ligaments of shoulder girdle
        (S43)

S43.216S is a billable diagnosis code used to specify a medical diagnosis of anterior dislocation of unspecified sternoclavicular joint, sequela. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

S43.216S is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like anterior dislocation of unspecified sternoclavicular joint. According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.

Unspecified diagnosis codes like S43.216S are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Anterior dislocation of sternoclavicular joint
  • Anterior dislocation of sternoclavicular joint
  • Anterior dislocation of sternoclavicular joint
  • Closed fracture dislocation sternoclavicular joint, anterior
  • Closed traumatic dislocation, sternoclavicular joint, anterior
  • Fracture dislocation of sternoclavicular joint
  • Fracture dislocation of sternoclavicular joint
  • Open fracture dislocation sternoclavicular joint, anterior
  • Open traumatic dislocation sternoclavicular joint
  • Open traumatic dislocation sternoclavicular joint
  • Open traumatic dislocation, sternoclavicular joint, anterior
  • Open traumatic dislocation, sternoclavicular joint, anterior

Clinical Classification

Coding Guidelines

The appropriate 7th character is to be added to each code from block Dislocation and sprain of joints and ligaments of shoulder girdle (S43). Use the following options for the aplicable episode of care:

  • A - initial encounter
  • D - subsequent encounter
  • S - sequela

Present on Admission (POA)

S43.216S is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.

CMS POA Indicator Options and Definitions

POA IndicatorReason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert S43.216S to ICD-9-CM

  • ICD-9-CM Code: 905.6 - Late effect dislocation
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education


Dislocated Shoulder

What is a dislocated shoulder?

Your shoulder joint is made up of three bones: your collarbone, your shoulder blade, and your upper arm bone. The top of your upper arm bone is shaped like a ball. This ball fits into a cuplike socket in your shoulder blade. A shoulder dislocation is an injury that happens when the ball pops out of your socket. A dislocation may be partial, where the ball is only partially out of the socket. It can also be a full dislocation, where the ball is completely out of the socket.

What causes a dislocated shoulder?

Your shoulders are the most movable joints in your body. They are also the most commonly dislocated joints.

The most common causes of shoulder dislocations are:

  • Sports injuries
  • Accidents, including traffic accidents
  • Falling on your shoulder or outstretched arm
  • Seizures and electric shocks, which can cause muscle contractions that pull the arm out of place

Who is at risk for a dislocated shoulder?

A dislocated shoulder can happen to anyone, but they are more common in young men, who are more often involved in sports and other physical activities. Older adults, especially women, are also at higher risk because they are more likely to fall.

What are the symptoms of a dislocated shoulder?

The symptoms of a dislocated shoulder include:

  • Severe shoulder pain
  • Swelling and bruising of your shoulder or upper arm
  • Numbness and/or weakness in your arm, neck, hand, or fingers
  • Trouble moving your arm
  • Your arm seems to be out of place
  • Muscle spasms in your shoulder

If you are having these symptoms, get medical treatment right away.

How is a dislocated shoulder diagnosed?

To make a diagnosis, your health care provider will take a medical history and examine your shoulder. Your provider may also ask you to get an x-ray to confirm the diagnosis.

What are the treatments for a dislocated shoulder?

The treatment for dislocated shoulder usually involves three steps:

  • The first step is a closed reduction, a procedure in which your health care provider puts the ball of your upper arm back into the socket. You may first get medicine to relieve the pain and relax your shoulder muscles. Once the joint is back in place, the severe pain should end.
  • The second step is wearing a sling or other device to keep your shoulder in place. You will wear it for a few days to several weeks.
  • The third step is rehabilitation, once the pain and swelling have improved. You will do exercises to improve your range of motion and strengthen your muscles.

You may need surgery if you injure the tissues or nerves around the shoulder or if you get repeated dislocations.

A dislocation can make your shoulder unstable. When that happens, it takes less force to dislocate it. This means that there is a higher risk of it happening again. Your health care provider may ask you to continue doing some exercises to prevent another dislocation.


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.