2027 ICD-10-CM Diagnosis Code S48.021APartial traumatic amputation at right shoulder joint, initial encounter

ICD-10-CM Codes›S00–T88›S40-S49›S48

ICD-10-CM S48.021A
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

S48.021A is a billable ICD-10-CM diagnosis code for partial traumatic amputation at right shoulder joint, 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 913 through 914, 963 through 965. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 309 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Amputation of a limb, initial encounter.

For Medicare Advantage risk adjustment, S48.021A maps to CMS-HCC Category 405 (Traumatic Amputations and Complications) under the V28 model, adding a risk factor of about 0.598 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
S48.021A
Billable Status
Yes — Valid for Submission
Code Describes
Partial traumatic amputation at right shoulder joint, initial encounter
Short Description
Partial traumatic amputation at right shoulder joint, init
Parent Code
S48.021
Partial traumatic amputation at right shoulder joint

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionS40-S49Injuries to the shoulder and upper arm
CategoryS48Traumatic amputation of shoulder and upper arm
This CodeS48.021APartial traumatic amputation at right shoulder joint, initial encounter

Medicare Risk Adjustment (HCC)Billing

S48.021A maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.

CMS-HCC V28 Category (Payment Model)
HCC 405— Traumatic Amputations and Complications
Payment HCC · PY 2027 one of 108 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.598
community, non-dual, aged · ranges 0.284–0.844 across segments
Hierarchy
Supersedes HCC 409
less severe related categories are not paid alongside HCC 405
Prior Model (CMS-HCC V24)
HCC 173
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 173 · ESRD (V21): HCC 173 · ESRD (V24): HCC 173
ESRD V21 weights: 0.042 dialysis, 0.061–0.290 functioning graft · ESRD V24 weights: 0.050 dialysis, 0.000–0.341 functioning graft
Part D (RxHCC)
Not mapped
S48.021A does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Coding GuidelinesGuidance

The appropriate 7th character is to be added to each code from block Traumatic amputation of shoulder and upper arm (S48). 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 S48.021A: its own notes plus those printed at S48, 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.

From Block S40-S49 Injuries to the shoulder and upper arm applies to 2,730 codes
  • injuries of axilla
  • injuries of scapular region

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From S48 Traumatic amputation of shoulder and upper arm applies to 54 codes
  • traumatic amputation at elbow level (S58.0)

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.

From Block S40-S49 Injuries to the shoulder and upper arm applies to 2,730 codes
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • code to identify any retained foreign body, if applicable (Z18.-)

Notes

General instructions on how these codes are used.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • 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.

From S48 Traumatic amputation of shoulder and upper arm applies to 54 codes
  • The appropriate 7th character is to be added to each code from category S48
Values for category S48 Encounter: Initial, Subsequent, Sequela
  • Ainitial encounter this code
  • Dsubsequent encounter
  • 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 S48.021A, its category, or a range that includes it.

Excludes1 2

These codes carry an Excludes1 note naming S48.021A: they are not reported together with it, unless the two conditions are unrelated.

  • S41 Open wound of shoulder and upper arm
    traumatic amputation of shoulder and upper arm (S48.-) names S48.-, which includes this code
  • S42 Fracture of shoulder and upper arm
    traumatic amputation of shoulder and upper arm (S48.-) names S48.-, which includes this code

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ014
Amputation of a limb, initial encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Limb Loss

People can lose all or part of an arm or leg for many reasons. Common ones include:

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert S48.021A to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
887.2 Amput abv elbow, unilat
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About S48.021AOverview

Is S48.021A (Partial traumatic amputation at right shoulder joint) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report partial traumatic amputation at right shoulder joint, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character A in S48.021A mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for partial traumatic amputation at right shoulder joint, such as an emergency visit or first evaluation.

What MS-DRG does S48.021A group to?

When partial traumatic amputation at right shoulder joint, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 964, 965, 914, 913, 963, with relative weights from 0.9281 to 2.6361 depending on complications. Higher weights mean higher Medicare reimbursement.

Is S48.021A a CC or MCC?

CMS lists S48.021A as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 309 closely related codes in its exclusion list.

Can S48.021A be reported with S58.0?

Not as a rule. The Excludes1 note at S48, which applies to S48.021A, lists "traumatic amputation at elbow level (S58.0)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

What HCC is S48.021A?

S48.021A (partial traumatic amputation at right shoulder joint, initial encounter) maps to CMS-HCC Category 405 (Traumatic Amputations and Complications), commonly written as HCC 405, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 173 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.

Does S48.021A risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, S48.021A adds a risk adjustment factor of about 0.598 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.284 to 0.844 depending on the payment segment). HCC 405 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 405 category page.