ICD-10 Code S43.491S

Other sprain of right shoulder joint, sequela

Version 2019 Billable Code POA Exempt
ICD-10: S43.491S
Short Description:Other sprain of right shoulder joint, sequela
Long Description:Other sprain of right shoulder joint, sequela

Valid for Submission

ICD-10 S43.491S is a billable code used to specify a medical diagnosis of other sprain of right shoulder joint, sequela. The code is valid for the year 2019 for the submission of HIPAA-covered transactions.

Code Classification

  • Injury, poisoning and certain other consequences of external causes (S00–T98)
    • Injuries to the shoulder and upper arm (S40-S49)
      • Disloc and sprain of joints and ligaments of shoulder girdle (S43)

Information for Medical Professionals

Convert S43.491S to ICD-9

The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:

  • 905.7 - Late effec sprain/strain (Approximate Flag)

Present on Admission (POA)

S43.491S is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement.

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

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

  • Sprains and strains
  • Dislocations
  • Separations
  • Tendinitis
  • Bursitis
  • Torn rotator cuffs
  • Frozen shoulder
  • Fractures
  • Arthritis

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

  • Brachial plexopathy (Medical Encyclopedia)
  • Broken collarbone - aftercare (Medical Encyclopedia)
  • Frozen shoulder (Medical Encyclopedia)
  • Frozen shoulder - aftercare (Medical Encyclopedia)
  • Shoulder arthroscopy (Medical Encyclopedia)
  • Shoulder CT scan (Medical Encyclopedia)
  • Shoulder MRI scan (Medical Encyclopedia)
  • Shoulder pain (Medical Encyclopedia)
  • Using your shoulder after surgery (Medical Encyclopedia)

[Learn More]

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

  • Ankle sprain - aftercare (Medical Encyclopedia)
  • Elbow sprain -- aftercare (Medical Encyclopedia)
  • Foot sprain - aftercare (Medical Encyclopedia)
  • Hamstring strain - aftercare (Medical Encyclopedia)
  • Hip flexor strain -- aftercare (Medical Encyclopedia)
  • Sprains (Medical Encyclopedia)
  • Strains (Medical Encyclopedia)
  • Tendon repair (Medical Encyclopedia)
  • Wrist sprain - aftercare (Medical Encyclopedia)

[Learn More]

ICD-10 Footnotes

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.