2027 ICD-10-CM Diagnosis Code S49.91XAUnspecified injury of right shoulder and upper arm, initial encounter

ICD-10-CM Codes›S00–T88›S40-S49›S49

ICD-10-CM S49.91XA
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

S49.91XA is a billable ICD-10-CM diagnosis code for unspecified injury of right shoulder and upper arm, 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. Coders also document this condition as injury of right shoulder. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other unspecified injury.

Code Identity

ICD-10-CM Code
S49.91XA
Billable Status
Yes — Valid for Submission
Code Describes
Unspecified injury of right shoulder and upper arm, initial encounter
Short Description
Unsp injury of right shoulder and upper arm, init encntr
Parent Code
S49.91
Unspecified injury of right shoulder and upper arm

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionS40-S49Injuries to the shoulder and upper arm
CategoryS49Other and unspecified injuries of shoulder and upper arm
This CodeS49.91XAUnspecified injury of right shoulder and upper arm, initial encounter

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Injury of right shoulder
  • Injury of right upper arm

Coding GuidelinesGuidance

The appropriate 7th character is to be added to each code from block Other and unspecified injuries of shoulder and upper arm (S49). 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 S49.91XA: its own notes plus those printed at S49.9, S49, 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

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 S49.9 Unspecified injury of shoulder and upper arm applies to 9 codes
  • The appropriate 7th character is to be added to each code in subcategory S49.9
From S49 Other and unspecified injuries of shoulder and upper arm applies to 234 codes
  • The appropriate 7th character is to be added to each code from subcategories S49.0 and S49.1
Values for category S49.9 Encounter: Initial, Subsequent, Sequela
  • 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.

CCSR INJ027
Other unspecified injury
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Arm Injuries and Disorders

Of the 206 bones in your body, three of them are in your arm: the humerus, radius, and ulna. Your arms are also made up of muscles, joints, tendons, and other connective tissue. Injuries to any of these parts of the arm can occur during sports, a fall, or an accident.

Read the full article at MedlinePlus

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

Convert S49.91XA to ICD-9-CMHistory

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

ICD-9-CM
959.2 Shldr/upper arm inj NOS
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 S49.91XAOverview

What is the ICD-10 code for unspecified injury of right shoulder and upper arm, initial encounter?

The ICD-10-CM code for unspecified injury of right shoulder and upper arm, initial encounter is S49.91XA (sometimes written as S4991XA). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is S49.91XA (Unspecified injury of right shoulder and upper arm) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report unspecified injury of right shoulder and upper arm, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character A in S49.91XA mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for unspecified injury of right shoulder and upper arm, such as an emergency visit or first evaluation.

What MS-DRG does S49.91XA group to?

When unspecified injury of right shoulder and upper arm, 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.

What is the ICD-9 equivalent of S49.91XA?

Under the General Equivalence Mappings, unspecified injury of right shoulder and upper arm, initial encounter converts to ICD-9-CM 959.2 (shldr/upper arm inj NOS). The mapping is approximate, so confirm the match fits the documentation.