ICD-10-CM Tabular Index · Chapter 19 · FY 2026 S40–S49
Injuries to the shoulder and upper arm (S40-S49) ICD-10-CM
The S40–S49 section covers injuries to the shoulder and upper arm with 3,546 ICD-10-CM diagnosis codes, of which 2,730 are billable in fiscal year 2026. The section is organized into the 10 code ranges listed below.
✓ Built from the official CMS FY 2026 datasetEffective Oct 1, 2025 – Sep 30, 2026
10
Code Ranges
3,546
Diagnosis Codes
2,730
Billable Codes
S40–S49
Code Range
Includes
This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
injuries of axilla
injuries of scapular region
Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
The info icon previews the code ranges inside each row and its instructional notations from the official Tabular List.
About the S40–S49 Code Range
ICD-10 codes S40 to S49 classify a wide range of injuries to the shoulder and upper arm. These include superficial injuries, wounds, fractures, dislocations, nerve injuries, vascular injuries, muscle and tendon injuries, and crushing injuries. The codes provide detailed specificity based on the injury type and affected side (right, left, or unspecified), as well as the encounter stage such as initial, subsequent, or sequelae.
This range covers superficial trauma like contusions, abrasions, and insect or animal bites, with codes such as S40 representing contusions and superficial injuries, including synonyms like "hematoma of shoulder region" or "contusion of clavicular area." Open wounds and lacerations are categorized in S41, detailing whether foreign bodies are involved. Fractures to the clavicle, scapula, and parts of the humerus—including specified types like displaced, nondisplaced, comminuted, or Salter-Harris physeal fractures—are covered extensively under S42 and S49. Dislocations and sprains of the shoulder girdle joints, including the shoulder, acromioclavicular, and sternoclavicular joints, are coded in S43. Nerve injuries at shoulder and upper arm level involving the ulnar, median, radial, axillary, musculocutaneous, and sensory nerves are classified in S44. Blood vessel injuries to axillary and brachial arteries and veins use codes in S45. Muscle and tendon injuries to key structures like the rotator cuff, long head of biceps, other parts of biceps, and triceps are found in S46. Lastly, crushing injuries and traumatic amputations of the shoulder and upper arm fall under S47 and S48, respectively.
These codes are essential for precisely identifying injury location and type to assist in clinical documentation, billing, and treatment planning for shoulder and upper arm injuries.
Questions About This Page
How many codes are in the S40-S49 range?
The S40-S49 range contains 3,546 ICD-10-CM diagnosis codes in FY 2026. 2,730 of them are billable, and the rest are category headers that organize the section.
What conditions does S40-S49 cover?
The range covers injuries to the shoulder and upper arm. The code ranges listed above break it into groups of related conditions, and each one links to its own page with the full code list.
Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
The appropriate 7th character is to be added to each code from category S40
7th Character
Indicates that a seventh character is to be assigned to codes in a subcategory.
A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
any associated wound infection
Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
traumatic amputation of shoulder and upper arm S48
Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
The appropriate 7th character is to be added to each code from category S41
7th Character
Indicates that a seventh character is to be assigned to codes in a subcategory.
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
traumatic amputation of shoulder and upper arm S48
Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
periprosthetic fracture around internal prosthetic shoulder joint M97.3
7th Character Note
Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
The appropriate 7th character is to be added to all codes from category S42
7th Character
Indicates that a seventh character is to be assigned to codes in a subcategory.
A - initial encounter for closed fracture
B - initial encounter for open fracture
D - subsequent encounter for fracture with routine healing
G - subsequent encounter for fracture with delayed healing
K - subsequent encounter for fracture with nonunion
P - subsequent encounter for fracture with malunion
S - sequela
A fracture not indicated as displaced or nondisplaced should be coded to displaced
A fracture not indicated as open or closed should be coded to closed
This note appears immediately under a three character code title to further define, or give 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
Code Also
A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
any associated open wound
Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
strain of muscle, fascia and tendon of shoulder and upper arm S46
7th Character Note
Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
The appropriate 7th character is to be added to each code from category S43
7th Character
Indicates that a seventh character is to be assigned to codes in a subcategory.
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
The appropriate 7th character is to be added to each code from category S44
7th Character
Indicates that a seventh character is to be assigned to codes in a subcategory.
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
The appropriate 7th character is to be added to each code from category S45
7th Character
Indicates that a seventh character is to be assigned to codes in a subcategory.
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
sprain of joints and ligaments of shoulder girdle S43.9
7th Character Note
Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
The appropriate 7th character is to be added to each code from category S46
7th Character
Indicates that a seventh character is to be assigned to codes in a subcategory.
The “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
code for all associated injuries
Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
The appropriate 7th character is to be added to each code from category S47
7th Character
Indicates that a seventh character is to be assigned to codes in a subcategory.
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
An amputation not identified as partial or complete should be coded to complete
Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
The appropriate 7th character is to be added to each code from category S48
7th Character
Indicates that a seventh character is to be assigned to codes in a subcategory.
Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
The appropriate 7th character is to be added to each code from subcategories S49.0S49.1
7th Character
Indicates that a seventh character is to be assigned to codes in a subcategory.
A - initial encounter for closed fracture
D - subsequent encounter for fracture with routine healing
G - subsequent encounter for fracture with delayed healing
K - subsequent encounter for fracture with nonunion
P - subsequent encounter for fracture with malunion
