2026 ICD-10-CM Diagnosis Code S40.249SExternal constriction of unspecified shoulder, sequela
S40.249S is a billable ICD-10-CM diagnosis code for external constriction of unspecified shoulder, 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 604 through 605. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Injury, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
S40.249S is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Superficial injury of shoulder and upper arm (S40). 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
Wounds and Injuries
An injury is damage to your body. It is a general term that refers to harm caused by accidents, falls, hits, weapons, and more. In the U.S., millions of people injure themselves every year. These injuries range from minor to life-threatening.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S40.249S to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S40.249SOverview
Is S40.249S (External constriction of unspecified shoulder) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report external constriction of unspecified shoulder, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in S40.249S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the external constriction of unspecified shoulder itself has resolved, not the original event.
What MS-DRG does S40.249S group to?
When external constriction of unspecified shoulder, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 604, 605, with relative weights from 0.9160 to 1.4721 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S40.249S 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 external constriction of unspecified shoulder, sequela on inpatient claims.
What is the ICD-9 equivalent of S40.249S?
Under the General Equivalence Mappings, external constriction of unspecified shoulder, sequela converts to ICD-9-CM 906.2 (late eff superficial inj). 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.
