The article discusses shoulder dislocation, a common contact sports injury, and its ICD-10 codes.
As the shoulder is one of most flexible joints, it is more prone to dislocation. Shoulder dislocation is a common injury treated by orthopedic specialists. It occurs when the upper arm bone pops out of the cup-shaped socket that is part of the shoulder blade. While reporting shoulder dislocation diagnosis and treatment, it is important to ensure thorough documentation and assign the correct medical codes. Orthopedic specialists/surgeons can rely on a professional medical billing company to accurately report the condition on claims and receive maximum reimbursement.
Dislocated shoulders are more common in teens than younger children. Typically, a dislocation occurs when a strong fall or blow to the shoulder causes to pull the bones out of place. Most cases of dislocations occur through the front of the shoulder. This can happen during contact sports, falls, and other types of trauma not related to sports.
Common symptoms include extreme pain and/or weakness, swelling, bruising and redness, muscle spasms, inability to move the joint, a visibly deformed or out-of-place shoulder and immobility or difficulty moving the arm. In addition, shoulder dislocation can also cause numbness, weakness or tingling near the injury, such as in the neck or down the arm, hand or fingers. The muscles in the shoulder may spasm, which can increase the pain.
If left untreated, shoulder dislocation can lead to several complications like – tearing of the muscles, ligaments and tendons, nerve or blood vessel damage and stretched or torn ligaments or tendons.
ICD-10 Codes for Shoulder Dislocation
Diagnosis of shoulder dislocation begins with a detailed checking or analysis of the affected area for tenderness, swelling or deformity. It may also involve checking for signs related to nerve or blood vessel injury. Other imaging tests like – X-ray, Electromyography (EMG) and MRI of the shoulder joint will also be taken to show the dislocation and identify broken bones or other damage to the shoulder joint. Treatment for this condition involves a combination of medications, immobilization (wearing a special splint or sling) and surgery.
The ICD-10 code for shoulder dislocation is S43. The ICD-10 codes for shoulder dislocations consist of seven characters. The seventh character denotes the encounter (initial, subsequent, or sequela).
- S43.001A Unspecified subluxation of right shoulder joint, initial encounter
- S43.001D Unspecified subluxation of right shoulder joint, subsequent encounter
- S43.001S Unspecified subluxation of right shoulder joint, sequela
- S43.002A Unspecified subluxation of left shoulder joint, initial encounter
- S43.002D Unspecified subluxation of left shoulder joint, subsequent encounter
- S43.002S Unspecified subluxation of left shoulder joint, sequela
- S43.003A Unspecified subluxation of unspecified shoulder joint, initial encounter
- S43.003D Unspecified subluxation of unspecified shoulder joint, subsequent encounter
- S43.003S Unspecified subluxation of unspecified shoulder joint, sequela
- S43.004A Unspecified dislocation of right shoulder joint, initial encounter
- S43.004D Unspecified dislocation of right shoulder joint, subsequent encounter
- S43.004S Unspecified dislocation of right shoulder joint, sequela
- S43.005A Unspecified dislocation of left shoulder joint, initial encounter
- S43.005D Unspecified dislocation of left shoulder joint, subsequent encounter
- S43.005S Unspecified dislocation of left shoulder joint, sequela
- S43.006A Unspecified dislocation of unspecified shoulder joint, initial encounter
- S43.006D Unspecified dislocation of unspecified shoulder joint, subsequent encounter
- S43.006S Unspecified dislocation of unspecified shoulder joint, sequel
To ensure correct coding, the documentation should specify the positioning, location of the dislocation including laterality (right or left), joint involved, the extent of the dislocation, and encounter. In addition, it should include the cause of the injury.
Having a dislocated shoulder joint can increase the risk of future shoulder dislocations. Taking care to avoid falls and other shoulder injuries, wearing protective gear when playing contact sports, and regularly doing strength and flexibility exercises can help maintain joint and muscle stability and prevent the occurrence of further injuries.
Medical billing and coding for orthopedic conditions can be complex. Medical billing and coding companies providing the services of AAPC-certified coding specialists can provide the right support for physicians to ensure accurate medical coding and claim submission to payers.
