ICD-10 Coding for Dislocated Right Shoulder(S43.004A)
Complete ICD-10-CM coding and documentation guide for Dislocated Right Shoulder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Dislocated Right Shoulder
S43.00-S43.09Primary Range
Dislocation and sprain of joints and ligaments of shoulder girdle
This range includes codes for various types of shoulder dislocations, including anterior, posterior, and unspecified dislocations.
Key Information: ICD-10 code for dislocated right shoulder
Essential facts and insights about Dislocated Right Shoulder
Primary ICD-10-CM Code for dislocated right shoulder
Decision Criteria
clinical Criteria
- Presence of shoulder dislocation confirmed by imaging
documentation Criteria
- Documentation of encounter type and laterality
Applicable To
- Initial encounter for right shoulder dislocation
Excludes
- Fracture of shoulder
- Subluxation of shoulder
Clinical Validation Requirements
- Clinical examination confirming dislocation
- Imaging such as X-ray or MRI showing dislocation
Code-Specific Risks
- Risk of using unspecified code leading to denial of claims
Coding Notes
- Ensure laterality and encounter type are documented to avoid unspecified coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Car occupant injured in collision with fixed or stationary object, initial encounter
V43.52XADifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Anterior dislocation of right shoulder, initial encounter
S43.014ADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Dislocated Right Shoulder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S43.004A.
Impact
Clinical: Incomplete clinical picture of the injury., Regulatory: Non-compliance with ICD-10 Chapter 20 guidelines., Financial: Potential for claim denials.
Mitigation Strategy
Always document the mechanism of injury., Use appropriate external cause codes.
Impact
Reimbursement: Claims may be denied or delayed., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate data for clinical and research purposes.
Mitigation Strategy
Always document and code the laterality of the dislocation.
Impact
Using unspecified codes without proper documentation.
Mitigation Strategy
Ensure all documentation includes laterality and encounter type.
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 Dislocated Right Shoulder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Dislocated Right Shoulder
Use these documentation templates to ensure complete and accurate documentation for Dislocated Right Shoulder. These templates include all required elements for proper coding and billing.
Initial Encounter for Right Shoulder Dislocation
Specialty: Emergency MedicineRequired Elements
- Patient demographics
- Mechanism of injury
- Clinical findings
- Imaging results
- Treatment provided
- Follow-up instructions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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