2027 ICD-10-CM Diagnosis Code S46.191DOther injury of muscle, fascia and tendon of long head of biceps, right arm, subsequent encounter
S46.191D is a billable ICD-10-CM diagnosis code for other injury of muscle, fascia and tendon of long head of biceps, right arm, subsequent encounter. The 7th character D marks it as a subsequent encounter code, used during routine care in the healing or recovery phase. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 949 through 950. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Injury to nerves, muscles and tendons, subsequent encounter.
Code Identity
Code Classification
Present on Admission (POA)Billing
S46.191D is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Injuries to the shoulder and upper arm (S40-S49).
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Injury of muscle, fascia and tendon at shoulder and upper arm level (S46). 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 S46.191D: its own notes plus those printed at S46, 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.
- 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.
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.
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 S46
- Ainitial encounter
- Dsubsequent encounter this code
- Ssequela
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name S46.191D, its category, or a range that includes it.
Excludes2 1
These codes carry an Excludes2 note naming S46.191D: its condition is not part of those codes, and both may be reported when the patient has both.
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 S46.191D to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S46.191DOverview
Is S46.191D a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report other injury of muscle, fascia and tendon of long head of biceps, right arm, subsequent encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character D in S46.191D mean?
The final character D marks a subsequent encounter: use it for routine care while the other injury of muscle, fascia and tendon of long head of biceps, right arm is healing, after active treatment has ended.
What MS-DRG does S46.191D group to?
When other injury of muscle, fascia and tendon of long head of biceps, right arm, subsequent encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 950, 949, with relative weights from 0.7661 to 1.1231 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S46.191D 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 other injury of muscle, fascia and tendon of long head of biceps, right arm, subsequent encounter on inpatient claims. The code appears in the Injuries to the shoulder and upper arm (S40-S49) range of the CMS exempt list.
What is the ICD-9 equivalent of S46.191D?
Under the General Equivalence Mappings, other injury of muscle, fascia and tendon of long head of biceps, right arm, subsequent encounter converts to ICD-9-CM V58.89 (other specfied aftercare). The mapping is approximate, so confirm the match fits the documentation.
