Valid for Submission
S46.099D is a billable diagnosis code used to specify a medical diagnosis of other injury of muscle(s) and tendon(s) of the rotator cuff of unspecified shoulder, subsequent encounter. The code S46.099D is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.
The ICD-10-CM code S46.099D might also be used to specify conditions or terms like traumatic rupture of rotator cuff. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
S46.099D is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like other injury of muscle(s) and tendon(s) of the rotator cuff of unspecified shoulder. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.
Unspecified diagnosis codes like S46.099D 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 Injury of muscle, fascia and tendon at shldr/up arm (S46). Use the following options for the aplicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Traumatic rupture of rotator cuff
Diagnostic Related Groups - MS-DRG Mapping
Present on Admission (POA)
Convert S46.099D to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code S46.099D its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
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
- Rotator cuff - self-care (Medical Encyclopedia)
- Rotator cuff exercises (Medical Encyclopedia)
- Rotator cuff problems (Medical Encyclopedia)
- Rotator cuff repair (Medical Encyclopedia)
- Shoulder arthroscopy (Medical Encyclopedia)
- Shoulder replacement (Medical Encyclopedia)
[Learn More in MedlinePlus]