Version 2024

2024 ICD-10-CM Diagnosis Code S03.41XD

Sprain of jaw, right side, subsequent encounter

ICD-10-CM:: S03.41XD
Short Description:: Sprain of jaw, right side, subsequent encounter
Is Billable?: Yes - Valid for Submission
Code Navigator:

Code Classification

Injury, poisoning and certain other consequences of external causes
(S00–T88)
- Injuries to the head
  (S00-S09)
  - Dislocation and sprain of joints and ligaments of head
    (S03)

S03.41XD is a billable diagnosis code used to specify a medical diagnosis of sprain of jaw, right side, subsequent encounter. 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.

S03.41XD is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like sprain of jaw right side. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.

1. Approximate Synonyms
2. Coding Guidelines
3. Tabular List of Diseases and Injuries
4. Diagnostic Related Groups - MS-DRG Mapping
5. Present on Admission (POA)
6. Replacement Code
7. Convert to ICD-9 Code
8. Patient Education
9. Other Codes Used Similar Conditions
10. Code History

Approximate Synonyms

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

Right jaw sprain
Sprain of jaw

Coding Guidelines

The appropriate 7th character is to be added to each code from block Dislocation and sprain of joints and ligaments of head (S03). Use the following options for the aplicable episode of care:

A - initial encounter
D - subsequent encounter
S - sequela

Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
949	AFTERCARE WITH CC/MCC	23	1.0361
950	AFTERCARE WITHOUT CC/MCC	23	0.6282

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Present on Admission (POA)

S03.41XD 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 Indicator	Reason for Code	CMS will pay the CC/MCC DRG?
Y	Diagnosis was present at time of inpatient admission.	YES
N	Diagnosis was not present at time of inpatient admission.	NO
U	Documentation insufficient to determine if the condition was present at the time of inpatient admission.	NO
W	Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.	YES
1	Unreported/Not used - Exempt from POA reporting.	NO

Replacement Code

S0341XD replaces the following previously assigned ICD-10-CM code(s):

S03.4XXD - Sprain of jaw, subsequent encounter

Convert to ICD-9-CM Code

Source ICD-10-CM Code		Target ICD-9-CM Code
S03.41XD		V58.89 - Other specfied aftercare
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

Jaw Injuries and Disorders

Your jaw is a set of bones that holds your teeth. It consists of two main parts. The upper part is the maxilla. It doesn't move. The moveable lower part is called the mandible. You move it when you talk or chew. The two halves of the mandible meet at your chin. The joint where the mandible meets your skull is the temporomandibular joint.

Jaw problems include:

Fractures (broken bones)
Dislocations
Temporomandibular joint dysfunction
Osteonecrosis, which happens when your bones lose their blood supply
Cancers

Treatment of jaw problems depends on the cause.

[Learn More in MedlinePlus]

Sprains and Strains

A sprain is a stretched or torn ligament. Ligaments are tissues that connect bones at a joint. Falling, twisting, or getting hit can all cause a sprain. Ankle and wrist sprains are common. Symptoms include pain, swelling, bruising, and being unable to move your joint. You might feel a pop or tear when the injury happens.

A strain is a stretched or torn muscle or tendon. Tendons are tissues that connect muscle to bone. Twisting or pulling these tissues can cause a strain. Strains can happen suddenly or develop over time. Back and hamstring muscle strains are common. Many people get strains playing sports. Symptoms include pain, muscle spasms, swelling, and trouble moving the muscle.

At first, treatment of both sprains and strains usually involves resting the injured area, icing it, wearing a bandage or device that compresses the area, and medicines. Later treatment might include exercise and physical therapy.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases