2026 ICD-10-CM Diagnosis Code S03.43XASprain of jaw, bilateral, initial encounter
S03.43XA is a billable ICD-10-CM diagnosis code for sprain of jaw, bilateral, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 157 through 159, 963 through 965. Coders also document this condition as bilateral jaw sprain. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Any dental condition including traumatic injury; and Sprains and strains, initial encounter.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Bilateral jaw sprain
- Left jaw sprain
- Right 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 S03.43XA to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code History & ChangesHistory
Replacement S03.43XA replaces the following previously assigned code(s):
- S03.4XXA - Sprain of jaw, initial encounter
Questions About S03.43XAOverview
Is S03.43XA (Sprain of jaw, bilateral) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report sprain of jaw, bilateral, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in S03.43XA mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for sprain of jaw, such as an emergency visit or first evaluation.
What MS-DRG does S03.43XA group to?
When sprain of jaw, bilateral, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 157, 158, 159, 963, 964, 965, with relative weights from 0.7085 to 2.7338 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of S03.43XA?
Under the General Equivalence Mappings, sprain of jaw, bilateral, initial encounter converts to ICD-9-CM 848.1 (sprain of jaw). 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.
