ICD-10 Coding for Acromioclavicular Joint Separation(S43.121A, S43.111A)
Complete ICD-10-CM coding and documentation guide for Acromioclavicular Joint Separation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Acromioclavicular Joint Separation
S43.1-Primary Range
Dislocation and sprain of joints and ligaments of shoulder girdle
This range includes codes specific to AC joint separations, classified by severity and laterality.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S43.121A | Subluxation of acromioclavicular joint, initial encounter | Use for Grade II separations with partial ligament tears and subluxation. |
|
| S43.111A | Dislocation of acromioclavicular joint, initial encounter | Use for Grade III or higher separations with complete ligament tears. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for AC joint separation
Essential facts and insights about Acromioclavicular Joint Separation
Primary ICD-10-CM Codes for before meals joint separation
Decision Criteria
clinical Criteria
- Grade II separation with partial ligament tear
documentation Criteria
- Imaging shows <50% clavicular displacement
Applicable To
- Grade II AC joint separation
Excludes
- Complete dislocation (S43.111A)
Clinical Validation Requirements
- Documentation of Grade II separation
- Imaging showing <50% clavicular displacement
Code-Specific Risks
- Misclassification as unspecified dislocation
Coding Notes
- Ensure documentation specifies grade and laterality.
S43.111A - Dislocation of acromioclavicular joint, initial encounter
Use for Grade III or higher separations with complete ligament tears.
Applicable To
- Grade III AC joint separation
Excludes
- Subluxation (S43.121A)
Clinical Validation Requirements
- Complete ligament tear
- Imaging showing >100% clavicular displacement
Coding Notes
Ensure documentation specifies grade and laterality.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Pain in right shoulder
M25.511Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Acromioclavicular Joint Separation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S43.121A.
Impact
Clinical: Inaccurate treatment planning, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Always include laterality in documentation, Use templates that prompt for laterality
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement issues., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies the Rockwood grade and laterality.
Impact
Use of unspecified codes when specific grades are documented.
Mitigation Strategy
Educate providers on the importance of documenting specific grades and laterality.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Acromioclavicular Joint Separation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Acromioclavicular Joint Separation
Use these documentation templates to ensure complete and accurate documentation for Acromioclavicular Joint Separation. These templates include all required elements for proper coding and billing.
Orthopedic Progress Note
Specialty: OrthopedicsRequired Elements
- Location and laterality of injury
- Mechanism of injury
- Imaging findings
- Physical exam results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Acromioclavicular Joint Separation? Ask your questions below.