2026 ICD-10-CM Diagnosis Code S03.42XSSprain of jaw, left side, sequela
S03.42XS is a billable ICD-10-CM diagnosis code for sprain of jaw, left side, sequela. The 7th character S marks it as a sequela code, which reports a problem that remains after the original condition has resolved. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 562 through 563. The code is exempt from POA reporting. Coders also document this condition as left jaw sprain. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Any dental condition including traumatic injury; and Injury, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
S03.42XS is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Left jaw sprain
- Sprain of jaw
Coding GuidelinesGuidance
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 applicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026, published by CMS and the National Center for Health Statistics.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Jaw Injuries and Disorders
Your jaw is a set of bones that holds your teeth. It includes:
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S03.42XS to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code History & ChangesHistory
Replacement S03.42XS replaces the following previously assigned code(s):
- S03.4XXS - Sprain of jaw, sequela
Questions About S03.42XSOverview
Is S03.42XS (Sprain of jaw, left side) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report sprain of jaw, left side, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in S03.42XS mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the sprain of jaw, left side itself has resolved, not the original event.
What MS-DRG does S03.42XS group to?
When sprain of jaw, left side, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 562, 563, with relative weights from 0.8955 to 1.4248 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S03.42XS exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for sprain of jaw, left side, sequela on inpatient claims.
What is the ICD-9 equivalent of S03.42XS?
Under the General Equivalence Mappings, sprain of jaw, left side, sequela converts to ICD-9-CM 905.7 (late effec sprain/strain). The mapping is approximate, so confirm the match fits the documentation.
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.
