ICD-10-CM Billable Code

S43.5

Sprain of acromioclavicular joint

Clinical Classification Guidelines

Inclusion Terms

  • Sprain of acromioclavicular ligament

Medical Intelligence & Overview

A sprain of the acromioclavicular (AC) joint, classified under ICD-10 code S43.5, occurs when the ligaments connecting the collarbone (clavicle) to the shoulder blade (scapula) are stretched or torn. This type of injury is often caused by a direct blow or trauma to the shoulder, leading to pain, swelling, and difficulty moving the arm. The AC joint plays a crucial role in shoulder stability and movement, making injuries to it significant for daily activities and athletic performance.

Causes & Symptoms

Clinical Causes: Falling directly onto the shoulder or outstretched arm Sports injuries, especially contact sports like football, rugby, or cycling accidents Trauma from a fall or accident involving a collision or impact Car or bicycle accidents Heavy lifting or sudden jerking movements that strain the shoulder

Key Symptoms: Pain at the top of the shoulder, especially near the collarbone Tenderness when touching the AC joint Swelling and possible bruising around the shoulder Decreased range of motion or stiffness in the shoulder A popping or tearing sensation at the time of injury Weakness in the shoulder or arm Discomfort when lifting or moving the arm across the chest

Diagnostic & Treatment

Diagnosis Path: Diagnosing a sprain of the acromioclavicular joint involves a combination of physical examination and medical history review. During the exam, a healthcare provider may perform specific tests to assess shoulder stability and identify tenderness or swelling. Imaging studies such as X-rays are often utilized to rule out fractures and to determine the severity of ligament injury or joint separation. In some cases, MRI scans may be recommended to evaluate soft tissue damage more precisely.

Treatment Protocols: Treatment strategies focus on relieving pain, reducing swelling, and restoring shoulder function. Common approaches include:

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

Clinical Advice & FAQs

Billing Guidance

Is S43.5 a billable ICD-10 code?
Yes, S43.5 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report S43.5?
Clinical documentation must specify the nature of Sprain of acromioclavicular joint and any associated comorbidities for accurate reporting.

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