2021 ICD-10-CM Code S43.4

Sprain of shoulder joint

Version 2021

Not Valid for Submission

S43.4 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of sprain of shoulder joint. The code is not specific and is NOT valid for the year 2021 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Short Description:Sprain of shoulder joint
Long Description:Sprain of shoulder joint

Code Classification

Specific Coding for Sprain of shoulder joint

Non-specific codes like S43.4 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for sprain of shoulder joint:

  • Use S43.40 for Unspecified sprain of shoulder joint
  • Use S43.401 for Unspecified sprain of right shoulder joint
  • Use S43.401A for initial encounter
  • Use S43.401D for subsequent encounter
  • Use S43.401S for sequela
  • Use S43.402 for Unspecified sprain of left shoulder joint
  • Use S43.402A for initial encounter
  • Use S43.402D for subsequent encounter
  • Use S43.402S for sequela
  • Use S43.409 for Unspecified sprain of unspecified shoulder joint
  • Use S43.409A for initial encounter
  • Use S43.409D for subsequent encounter
  • Use S43.409S for sequela
  • Use S43.41 for Sprain of coracohumeral (ligament)
  • Use S43.411 for Sprain of right coracohumeral (ligament)
  • Use S43.411A for initial encounter
  • Use S43.411D for subsequent encounter
  • Use S43.411S for sequela
  • Use S43.412 for Sprain of left coracohumeral (ligament)
  • Use S43.412A for initial encounter
  • Use S43.412D for subsequent encounter
  • Use S43.412S for sequela
  • Use S43.419 for Sprain of unspecified coracohumeral (ligament)
  • Use S43.419A for initial encounter
  • Use S43.419D for subsequent encounter
  • Use S43.419S for sequela
  • Use S43.42 for Sprain of rotator cuff capsule
  • Use S43.421 for Sprain of right rotator cuff capsule
  • Use S43.421A for initial encounter
  • Use S43.421D for subsequent encounter
  • Use S43.421S for sequela
  • Use S43.422 for Sprain of left rotator cuff capsule
  • Use S43.422A for initial encounter
  • Use S43.422D for subsequent encounter
  • Use S43.422S for sequela
  • Use S43.429 for Sprain of unspecified rotator cuff capsule
  • Use S43.429A for initial encounter
  • Use S43.429D for subsequent encounter
  • Use S43.429S for sequela
  • Use S43.43 for Superior glenoid labrum lesion
  • Use S43.431 for Superior glenoid labrum lesion of right shoulder
  • Use S43.431A for initial encounter
  • Use S43.431D for subsequent encounter
  • Use S43.431S for sequela
  • Use S43.432 for Superior glenoid labrum lesion of left shoulder
  • Use S43.432A for initial encounter
  • Use S43.432D for subsequent encounter
  • Use S43.432S for sequela
  • Use S43.439 for Superior glenoid labrum lesion of unspecified shoulder
  • Use S43.439A for initial encounter
  • Use S43.439D for subsequent encounter
  • Use S43.439S for sequela
  • Use S43.49 for Other sprain of shoulder joint
  • Use S43.491 for Other sprain of right shoulder joint
  • Use S43.491A for initial encounter
  • Use S43.491D for subsequent encounter
  • Use S43.491S for sequela
  • Use S43.492 for Other sprain of left shoulder joint
  • Use S43.492A for initial encounter
  • Use S43.492D for subsequent encounter
  • Use S43.492S for sequela
  • Use S43.499 for Other sprain of unspecified shoulder joint
  • Use S43.499A for initial encounter
  • Use S43.499D for subsequent encounter
  • Use S43.499S for sequela

Information for Patients

Shoulder Injuries and Disorders

Your shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone). Your shoulders are the most movable joints in your body. They can also be unstable because the ball of the upper arm is larger than the shoulder socket that holds it. To remain in a stable or normal position, the shoulder must be anchored by muscles, tendons, and ligaments.

Because your shoulder can be unstable, it can be easily injured. Common problems include

Health care providers diagnose shoulder problems by using your medical history, a physical exam, and imaging tests.

Often, the first treatment for shoulder problems is RICE. This stands for Rest, Ice, Compression, and Elevation. Other treatments include exercise and medicines to reduce pain and swelling. If those don't work, you may need surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

[Learn More in MedlinePlus]

Sprains and Strains

A sprain is a stretched or torn ligament. Ligaments are tissues that connect bones at a joint. Falling, twisting, or getting hit can all cause a sprain. Ankle and wrist sprains are common. Symptoms include pain, swelling, bruising, and being unable to move your joint. You might feel a pop or tear when the injury happens.

A strain is a stretched or torn muscle or tendon. Tendons are tissues that connect muscle to bone. Twisting or pulling these tissues can cause a strain. Strains can happen suddenly or develop over time. Back and hamstring muscle strains are common. Many people get strains playing sports. Symptoms include pain, muscle spasms, swelling, and trouble moving the muscle.

At first, treatment of both sprains and strains usually involves resting the injured area, icing it, wearing a bandage or device that compresses the area, and medicines. Later treatment might include exercise and physical therapy.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

[Learn More in MedlinePlus]

Code History

  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)