ICD-10 S43.396
Non-Billable HeaderDislocation of other parts of unspecified shoulder girdle
About ICD-10-CM S43.396
ICD-10-CM code S43.396 represents Dislocation of other parts of unspecified shoulder girdle. This is a non-billable header code in the Injury, Poisoning, and External Causes chapter (block S43). The 2026 edition of ICD-10-CM S43.396 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 S43.396
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.
Medicare LCD Coverage for S43.396
Local Coverage Determinations (LCDs) from CMS MACs that list S43.396 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 S43.396.
1 Aetna
CPT Codes Commonly Billed with S43.396
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 S43.396
Other codes in section S40-S49 (Injuries to the shoulder and upper arm).
ICD-10 S43.396, Billing FAQ
Is ICD-10 code S43.396 billable? +
No, S43.396 is a non-billable header code. Use a more specific child code from block S43 when submitting claims.
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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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