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

Note:: 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.

Use additional: code to identify any retained foreign body, if applicable (Z18.-)
Excludes 1:: birth trauma (P10-P15)
obstetric trauma (O70-O71)

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

Includes:: injuries of axilla
injuries of scapular region
Excludes 2:: burns and corrosions (T20-T32)
frostbite (T33-T34)
injuries of elbow (S50-S59)
insect bite or sting, venomous (T63.4)

S40

Superficial injury of shoulder and upper arm [+]

The appropriate 7th character is to be added to each code from category S40
A - initial encounter
D - subsequent encounter
S - sequela

S41

Open wound of shoulder and upper arm [+]

Code also	any associated wound infection
Excludes 1:	traumatic amputation of shoulder and upper arm (S48.-)
Excludes 2:	open fracture of shoulder and upper arm (S42.- with 7th character B or C)
The appropriate 7th character is to be added to each code from category S41 A - initial encounter D - subsequent encounter S - sequela

S42

Fracture of shoulder and upper arm [+]

Note:

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

Excludes 1:	traumatic amputation of shoulder and upper arm (S48.-)
Excludes 2:	periprosthetic fracture around internal prosthetic shoulder joint (M97.3)
The appropriate 7th character is to be added to all codes from category S42 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

S43

Dislocation and sprain of joints and ligaments of shoulder girdle [+]

Includes:	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	any associated open wound
Excludes 2:	strain of muscle, fascia and tendon of shoulder and upper arm (S46.-)
The appropriate 7th character is to be added to each code from category S43 A - initial encounter D - subsequent encounter S - sequela

S44

Injury of nerves at shoulder and upper arm level [+]

Code also	any associated open wound (S41.-)
Excludes 2:	injury of brachial plexus (S14.3-)
The appropriate 7th character is to be added to each code from category S44 A - initial encounter D - subsequent encounter S - sequela

S45

Injury of blood vessels at shoulder and upper arm level [+]

Code also	any associated open wound (S41.-)
Excludes 2:	injury of subclavian artery (S25.1) injury of subclavian vein (S25.3)
The appropriate 7th character is to be added to each code from category S45 A - initial encounter D - subsequent encounter S - sequela

S46

Injury of muscle, fascia and tendon at shoulder and upper arm level [+]

Code also	any associated open wound (S41.-)
Excludes 2:	injury of muscle, fascia and tendon at elbow (S56.-) sprain of joints and ligaments of shoulder girdle (S43.9)
The appropriate 7th character is to be added to each code from category S46 A - initial encounter D - subsequent encounter S - sequela

S47

Crushing injury of shoulder and upper arm [+]

Use additional	code for all associated injuries
Excludes 2:	crushing injury of elbow (S57.0-)
The appropriate 7th character is to be added to each code from category S47 A - initial encounter D - subsequent encounter S - sequela

S48

Traumatic amputation of shoulder and upper arm [+]
An amputation not identified as partial or complete should be coded to complete

Excludes 1:	traumatic amputation at elbow level (S58.0)
The appropriate 7th character is to be added to each code from category S48 A - initial encounter D - subsequent encounter S - sequela

S49

Other and unspecified injuries of shoulder and upper arm [+]

The appropriate 7th character is to be added to each code from subcategories S49.0 and S49.1
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
S - sequela