S43.42

Non-Billable

ChapterS00–T88

Ranksubcategory

Official Description

Sprain of rotator cuff capsule

Use a more specific code (3 billable)

Metadata & Insights

•Non-billable category (requires more specific sub-code).
•Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88).

Excludes1(Not coded here. Use a different code.)

rotator cuff syndrome (complete) (incomplete), not specified as traumatic (M75.1-)

Excludes2(Not included here. Code separately if applicable.)

General instructions are available for the parent sections:

BillableHas subcodes

CH19Injury, poisoning and certain other consequences of external causes (S00-T88)

S40-S49Injuries to the shoulder and upper arm (S40-S49)

S43Dislocation and sprain of joints and ligaments of shoulder girdle

S43.4Sprain of shoulder joint

S43.42Sprain of rotator cuff capsuleNot billable

S43.421Sprain of right rotator cuff capsuleBillable

S43.422Sprain of left rotator cuff capsuleBillable

S43.429Sprain of unspecified rotator cuff capsuleBillable

The following parent sections contain instructions or notes that apply to S43.42:

categoryS43

Dislocation and sprain of joints and ligaments of shoulder girdle

Injuries to the shoulder and upper arm (S40-S49)

chapterCH19

Injury, poisoning and certain other consequences of external causes (S00-T88)

2026

No direct MS-DRG triggers identified.

Find surgical and procedural codes related to Sprain of rotator cuff capsule.