2027 ICD-10-CM Diagnosis Code S41.149APuncture wound with foreign body of unspecified upper arm, initial encounter

ICD-10-CM Codes›S00–T88›S40-S49›S41

ICD-10-CM S41.149A
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

S41.149A is a billable ICD-10-CM diagnosis code for puncture wound with foreign body of unspecified upper arm, 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 913 through 914, 963 through 965. Coders also document this condition as fishing hook in axilla. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Open wounds to limbs, initial encounter.

Code Identity

ICD-10-CM Code
S41.149A
Billable Status
Yes — Valid for Submission
Code Describes
Puncture wound with foreign body of unspecified upper arm, initial encounter
Short Description
Puncture wound w foreign body of unsp upper arm, init encntr
Parent Code
S41.149
Puncture wound with foreign body of unspecified upper arm

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionS40-S49Injuries to the shoulder and upper arm
CategoryS41Open wound of shoulder and upper arm
This CodeS41.149APuncture wound with foreign body of unspecified upper arm, initial encounter

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Fishing hook in axilla
  • Fishing hook in shoulder
  • Fishing hook in upper arm
  • Puncture wound of upper arm
  • Puncture wound of upper arm with foreign body

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 S41.149A: 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.

From Block S40-S49 Injuries to the shoulder and upper arm applies to 2,730 codes
  • 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.

From S41 Open wound of shoulder and upper arm applies to 108 codes
  • traumatic amputation of shoulder and upper arm (S48.-)

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.

From S41 Open wound of shoulder and upper arm applies to 108 codes
  • open fracture of shoulder and upper arm (S42.- with 7th character B or C)
From Block S40-S49 Injuries to the shoulder and upper arm applies to 2,730 codes
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • 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.

From S41 Open wound of shoulder and upper arm applies to 108 codes
  • any associated wound infection

Notes

General instructions on how these codes are used.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • 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.

From S41 Open wound of shoulder and upper arm applies to 108 codes
  • The appropriate 7th character is to be added to each code from category S41
Values for category S41 Encounter: Initial, Subsequent, Sequela
  • 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 S41.149A, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming S41.149A: they are not reported together with it, unless the two conditions are unrelated.

  • S40.87 Other superficial bite of upper arm
    open bite of upper arm (S41.14) names S41.14, which includes this code

Code Also 3

These codes say S41.149A may also be needed to fully describe the condition. The note gives no sequencing direction.

  • S44 Injury of nerves at shoulder and upper arm level
    any associated open wound (S41.-) names S41.-, which includes this code
  • S45 Injury of blood vessels at shoulder and upper arm level
    any associated open wound (S41.-) names S41.-, which includes this code
  • S46 Injury of muscle, fascia and tendon at shoulder and upper arm level
    any associated open wound (S41.-) names S41.-, which includes this code

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ012
Open wounds to limbs, initial encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

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 S41.149A to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
880.13 Open wnd upper arm-compl
Approximate The match is approximate rather than exact.
ICD-9-CM
880.19 Mult opn wnd should-comp
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About S41.149AOverview

Is S41.149A (Puncture wound with foreign body of unspecified upper arm) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report puncture wound with foreign body of unspecified upper arm, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character A in S41.149A mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for puncture wound with foreign body of unspecified upper arm, such as an emergency visit or first evaluation.

What MS-DRG does S41.149A group to?

When puncture wound with foreign body of unspecified upper arm, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 964, 965, 914, 913, 963, with relative weights from 0.9281 to 2.6361 depending on complications. Higher weights mean higher Medicare reimbursement.

Can S41.149A be reported with a code from S48?

Not as a rule. The Excludes1 note at S41, which applies to S41.149A, 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).

What is the ICD-9 equivalent of S41.149A?

Under the General Equivalence Mappings, puncture wound with foreign body of unspecified upper arm, initial encounter converts to ICD-9-CM 880.13 (open wnd upper arm-compl) and 880.19 (mult opn wnd should-comp). The mapping is approximate, so confirm the match fits the documentation.