2026 ICD-10-CM Diagnosis Code S43.026SPosterior dislocation of unspecified humerus, sequela
S43.026S is a billable ICD-10-CM diagnosis code for posterior dislocation of unspecified humerus, sequela. The 7th character S marks it as a sequela code, which reports a problem that remains after the original condition has resolved. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 562 through 563. The code is exempt from POA reporting. Coders also document this condition as closed posterior dislocation of glenohumeral joint. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Injury, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
S43.026S is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Closed posterior dislocation of glenohumeral joint
- Closed traumatic dislocation shoulder joint, posterior
- Open dislocation of glenohumeral joint
- Open traumatic dislocation of glenohumeral joint, posterior
- Posterior dislocation of shoulder joint
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Dislocation and sprain of joints and ligaments of shoulder girdle (S43). 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 2026, published by CMS and the National Center for Health Statistics.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Dislocated Shoulder
Your shoulder joint is made up of three bones: your collarbone, your shoulder blade, and your upper arm bone. The top of your upper arm bone is shaped like a ball. This ball fits into a cuplike socket in your shoulder blade. A shoulder dislocation is an injury that happens when the ball pops out of your socket.
The full article covers:
- What is a dislocated shoulder?
- What causes a dislocated shoulder?
- Who is at risk for a dislocated shoulder?
- What are the symptoms of a dislocated shoulder?
- How is a dislocated shoulder diagnosed?
- What are the treatments for a dislocated shoulder?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S43.026S to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S43.026SOverview
Is S43.026S (Posterior dislocation of unspecified humerus) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report posterior dislocation of unspecified humerus, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in S43.026S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the posterior dislocation of unspecified humerus itself has resolved, not the original event.
What MS-DRG does S43.026S group to?
When posterior dislocation of unspecified humerus, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 562, 563, with relative weights from 0.8955 to 1.4248 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S43.026S 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 posterior dislocation of unspecified humerus, sequela on inpatient claims.
What is the ICD-9 equivalent of S43.026S?
Under the General Equivalence Mappings, posterior dislocation of unspecified humerus, sequela converts to ICD-9-CM 905.6 (late effect dislocation). The mapping is approximate, so confirm the match fits the documentation.
Footnotes
[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.
