2027 ICD-10-CM Diagnosis Code S41.139DPuncture wound without foreign body of unspecified upper arm, subsequent encounter
S41.139D is a billable ICD-10-CM diagnosis code for puncture wound without foreign body of unspecified upper arm, subsequent encounter. The 7th character D marks it as a subsequent encounter code, used during routine care in the healing or recovery phase. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 949 through 950. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Open wounds to limbs, subsequent encounter.
Code Identity
Code Classification
Present on Admission (POA)Billing
S41.139D is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Injuries to the shoulder and upper arm (S40-S49).
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Gunshot wound of axillary region
- Gunshot wound of shoulder region
- Gunshot wound of upper arm
- Nail wound of upper arm
- Needle stick injury of axilla
- Needle stick injury of shoulder
- Needle stick injury of upper arm
- Pellet wound of upper arm
- Puncture wound of axilla
- Puncture wound of upper arm
- Puncture wound of upper arm without foreign body
- Stab wound of upper arm
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Open wound of shoulder and upper arm (S41). 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 S41.139D: its own notes plus those printed at S41, block S40-S49, 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.
- injuries of axilla
- injuries of scapular region
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
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.
- open fracture of shoulder and upper arm (S42.- with 7th character B or C)
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 wound 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 S41
- Ainitial encounter
- Dsubsequent encounter this code
- 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 S41.139D, its category, or a range that includes it.
Code Also 3
These codes say S41.139D may also be needed to fully describe the condition. The note gives no sequencing direction.
- S44 Injury of nerves at shoulder and upper arm levelany associated open wound (S41.-) names S41.-, which includes this code
- S45 Injury of blood vessels at shoulder and upper arm levelany associated open wound (S41.-) names S41.-, which includes this code
- S46 Injury of muscle, fascia and tendon at shoulder and upper arm levelany associated open wound (S41.-) names S41.-, which includes this code
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Arm Injuries and Disorders
Of the 206 bones in your body, three of them are in your arm: the humerus, radius, and ulna. Your arms are also made up of muscles, joints, tendons, and other connective tissue. Injuries to any of these parts of the arm can occur during sports, a fall, or an accident.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S41.139D to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S41.139DOverview
Is S41.139D (Puncture wound without foreign body of unspecified upper arm) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report puncture wound without foreign body of unspecified upper arm, subsequent encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character D in S41.139D mean?
The final character D marks a subsequent encounter: use it for routine care while the puncture wound without foreign body of unspecified upper arm is healing, after active treatment has ended.
What MS-DRG does S41.139D group to?
When puncture wound without foreign body of unspecified upper arm, subsequent encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 950, 949, with relative weights from 0.7661 to 1.1231 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S41.139D 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 puncture wound without foreign body of unspecified upper arm, subsequent encounter on inpatient claims. The code appears in the Injuries to the shoulder and upper arm (S40-S49) range of the CMS exempt list.
Can S41.139D be reported with a code from S48?
Not as a rule. The Excludes1 note at S41, which applies to S41.139D, lists "traumatic amputation of shoulder and upper arm (S48.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).