ICD-10 S41
Non-Billable HeaderOpen wound of shoulder and upper arm
About ICD-10-CM S41
ICD-10-CM code S41 represents Open wound of shoulder and upper arm. This is a non-billable header code in the Injury, Poisoning, and External Causes chapter (block S41). The 2026 edition of ICD-10-CM S41 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Coding Tips for S41
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Injury codes require a 7th character: A (initial encounter, active treatment), D (subsequent, healing/recovery), S (sequela, late effect of original injury). Codes with fewer than 6 characters need the placeholder X to bring them to 6 characters before adding the 7th. Wrong or missing 7th character is the #1 cause of injury claim denials.
Type 1 Excludes
Pure excludes, these codes can never be coded together with S41. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- traumatic amputation of shoulder and upper arm (S48.-)
Type 2 Excludes
Not included here, the excluded code is not part of S41, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- open fracture of shoulder and upper arm (S42.- with 7th character B or C)
Coding Notes
Code Also
- any associated wound infection
Seven Chr Note
- The appropriate 7th character is to be added to each code from category S41
Medicare LCD Coverage for S41
Local Coverage Determinations (LCDs) from CMS MACs that list S41 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing S41.
1 Aetna
2 Cigna
2 Humana
CPT Codes Commonly Billed with S41
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To S41
Other codes in section S40-S49 (Injuries to the shoulder and upper arm).
ICD-10 S41, Billing FAQ
Is ICD-10 code S41 billable? +
No, S41 is a non-billable header code. Use a more specific child code from block S41 when submitting claims.
What codes are Type 1 Excludes for S41? +
Type 1 Excludes (never code together with S41): traumatic amputation of shoulder and upper arm (S48.-)
What codes are Type 2 Excludes for S41? +
Type 2 Excludes (may be coded together when both conditions exist): open fracture of shoulder and upper arm (S42.- with 7th character B or C)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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