2027 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 2027 (October 1, 2026 through September 30, 2027) 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 2027, published by CMS and the National Center for Health Statistics.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to S03.43XA: its own notes plus those printed at S03, block S00-S09, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- avulsion of joint (capsule) or ligament of head
- laceration of cartilage, joint (capsule) or ligament of head
- sprain of cartilage, joint (capsule) or ligament of head
- traumatic hemarthrosis of joint or ligament of head
- traumatic rupture of joint or ligament of head
- traumatic subluxation of joint or ligament of head
- traumatic tear of joint or ligament of head
- injuries of ear
- injuries of eye
- injuries of face [any part]
- injuries of gum
- injuries of jaw
- injuries of oral cavity
- injuries of palate
- injuries of periocular area
- injuries of scalp
- injuries of temporomandibular joint area
- injuries of tongue
- injuries of tooth
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- Strain of muscle or tendon of head (S09.1)
- burns and corrosions (T20-T32)
- effects of foreign body in ear (T16)
- effects of foreign body in larynx (T17.3)
- effects of foreign body in mouth NOS (T18.0)
- effects of foreign body in nose (T17.0-T17.1)
- effects of foreign body in pharynx (T17.2)
- effects of foreign body on external eye (T15.-)
- frostbite (T33-T34)
- insect bite or sting, venomous (T63.4)
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to identify any retained foreign body, if applicable (Z18.-)
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
- any associated open wound
- for any associated infection
Notes
General instructions on how these codes are used.
- Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
- The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.
7th Character
Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.
- The appropriate 7th character is to be added to each code from category S03
- Ainitial encounter this code
- Dsubsequent encounter
- Ssequela
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name S03.43XA, its category, or a range that includes it.
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
What is the ICD-10 code for sprain of jaw, bilateral, initial encounter?
The ICD-10-CM code for sprain of jaw, bilateral, initial encounter is S03.43XA (sometimes written as S0343XA). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
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, 2026 through September 30, 2027.
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 964, 965, 159, 158, 157, 963, with relative weights from 0.6890 to 2.6361 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.
