2027 ICD-10-CM Diagnosis Code S43.411ASprain of right coracohumeral (ligament), initial encounter
S43.411A is a billable ICD-10-CM diagnosis code for sprain of right coracohumeral (ligament), 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 562 through 563, 963 through 965. Coders also document this condition as coracohumeral sprain. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Sprains and strains, initial encounter.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Coracohumeral sprain
- Disorder of ligament of right shoulder joint
- Disorder of ligament of right shoulder region
- Sprain of ligament of right shoulder joint
- Sprain of right coracohumeral ligament
- Sprain of right rotator cuff capsule
- Sprain of shoulder
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 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 S43.411A: its own notes plus those printed at S43, 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.
- avulsion of joint or ligament of shoulder girdle
- laceration of cartilage, joint or ligament of shoulder girdle
- sprain of cartilage, joint or ligament of shoulder girdle
- traumatic hemarthrosis of joint or ligament of shoulder girdle
- traumatic rupture of joint or ligament of shoulder girdle
- traumatic subluxation of joint or ligament of shoulder girdle
- traumatic tear of joint or ligament of shoulder girdle
- injuries of axilla
- injuries of scapular region
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.
- strain of muscle, fascia and tendon of shoulder and upper arm (S46.-)
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- 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.
- any associated open wound
Notes
General instructions on how these codes are used.
- 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.
- The appropriate 7th character is to be added to each code from category S43
- Ainitial encounter this code
- Dsubsequent encounter
- Ssequela
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
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.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S43.411A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S43.411AOverview
What is the ICD-10 code for sprain of right coracohumeral (ligament), initial encounter?
The ICD-10-CM code for sprain of right coracohumeral (ligament), initial encounter is S43.411A (sometimes written as S43411A). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is S43.411A (Sprain of right coracohumeral (ligament)) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report sprain of right coracohumeral (ligament), initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character A in S43.411A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for sprain of right coracohumeral (ligament), such as an emergency visit or first evaluation.
What MS-DRG does S43.411A group to?
When sprain of right coracohumeral (ligament), initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 563, 964, 965, 562, 963, with relative weights from 0.8982 to 2.6361 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of S43.411A?
Under the General Equivalence Mappings, sprain of right coracohumeral (ligament), initial encounter converts to ICD-9-CM 840.2 (sprain coracohumeral). The mapping is approximate, so confirm the match fits the documentation.