ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 S46.812A

Billable / Specific

Strain of other muscles, fascia and tendons at shoulder and upper arm level, left arm, initial encounter

S46
Block
0
Synonyms
198
LCDs
6
Payer Policies
0
Linked CPTs

About ICD-10-CM S46.812A

ICD-10-CM code S46.812A represents Strain of other muscles, fascia and tendons at shoulder and upper arm level, left arm, initial encounter. This is a billable/specific code in the Injury, Poisoning, and External Causes chapter (block S46). The 2026 edition of ICD-10-CM S46.812A became effective on October 1, 2025.

Coding Tips for S46.812A

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Injury chapter (S00-T88): 7th character extension required

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 S46.812A

Local Coverage Determinations (LCDs) from CMS MACs that list S46.812A as a covered diagnosis.

198 LCDs

Showing top 10 of 198 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
Article ID: 57079, Effective: 2026-01-01 00:00:00, 662 covered, 0 non-covered
CPT 26341 →
CMS LCD: Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
Article ID: 57079, Effective: 2026-01-01 00:00:00, 662 covered, 0 non-covered
CPT 64632 →
CMS LCD: Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
Article ID: 57079, Effective: 2026-01-01 00:00:00, 662 covered, 0 non-covered
CPT 64455 →
CMS LCD: Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
Article ID: 57079, Effective: 2026-01-01 00:00:00, 662 covered, 0 non-covered
CPT 20526 →
CMS LCD: Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
Article ID: 57079, Effective: 2026-01-01 00:00:00, 662 covered, 0 non-covered
CPT 20612 →
CMS LCD: Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
Article ID: 57079, Effective: 2026-01-01 00:00:00, 662 covered, 0 non-covered
CPT 20527 →
CMS LCD: Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
Article ID: 57079, Effective: 2026-01-01 00:00:00, 662 covered, 0 non-covered
CPT 28899 →
CMS LCD: Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
Article ID: 57079, Effective: 2026-01-01 00:00:00, 662 covered, 0 non-covered
CPT 20550 →
CMS LCD: Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
Article ID: 57079, Effective: 2026-01-01 00:00:00, 662 covered, 0 non-covered
CPT 20551 →
CMS LCD: Billing and Coding: Nonvascular Extremity Ultrasound
Article ID: 56787, Effective: 2023-10-01 00:00:00, 1282 covered, 0 non-covered
CPT 76881 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing S46.812A.

6 policies

1 Cigna

Acupuncture - (CPG024)
Policy ID: CPG024_ACUPUNCTURE

5 Medicare

Billing and Coding: Home Health Physical Therapy
Policy ID: ART-53058
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065
Billing and Coding: Nonvascular Extremity Ultrasound
Policy ID: ART-56787
Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
Policy ID: ART-57079
Billing and Coding: Physical Therapy - Home Health
Policy ID: ART-57311

CPT Codes Commonly Billed with S46.812A

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for S46.812A

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.

Convert S46.812A to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
S46.812A 8408 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 S46.812A, Billing FAQ

Is ICD-10 code S46.812A billable? +

Yes, S46.812A is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What ICD-9 codes does S46.812A map to? +

Per CMS GEMs, S46.812A maps to ICD-9 codes: 8408. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on April 20, 2026.

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