Not Valid for Submission
S43.429 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 unspecified rotator cuff capsule. The code is not specific and is NOT valid for the year 2022 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.
The ICD-10-CM code S43.429 might also be used to specify conditions or terms like sprain of shoulder rotator cuff.
Unspecified diagnosis codes like S43.429 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
The appropriate 7th character is to be added to each code from block Disloc and sprain of joints and ligaments of shoulder girdle (S43). Use the following options for the aplicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Specific Coding for Sprain of unspecified rotator cuff capsule
Non-specific codes like S43.429 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 unspecified rotator cuff capsule:
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Sprain of shoulder rotator cuff
Information for Patients
Rotator Cuff Injuries
Your rotator cuff is located in your shoulder area. It is made of muscles and tendons. It helps your shoulder to move and stay stable. Problems with the rotator cuff are common. They include tendinitis, bursitis, and injuries such as tears.
Rotator cuff tendons can become inflamed from frequent use or aging. Sometimes they are injured from a fall on an outstretched hand. Sports or jobs with repeated overhead motion can also damage the rotator cuff. Aging causes tendons to wear down, which can lead to a tear.
Some tears are not painful, but others can be very painful. Treatment for a torn rotator cuff depends on age, health, how severe the injury is, and how long you've had the torn rotator cuff.
Treatment for torn rotator cuff includes:
- Heat or cold to the sore area
- Medicines that reduce pain and swelling
- Electrical stimulation of muscles and nerves
- Cortisone injection
NIH: National Institute of Arthritis and Musculoskeletal and Skin Disease
[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]