DxCodebookFY2027 · Oct 1, 2026 – Sep 30, 2027

Category · FY2027

S46 Injury of muscle, fascia and tendon at shoulder and upper arm level

  • Header · not billable
  • Codes take a 7th character

S46 is not billable. The category heads 216 billable codes in FY2027, grouped under 6 subdivisions. Its codes take a 7th character, so none is complete with fewer than 7 characters.

Index → code

  • Injuryrotator cuff (muscle(s)) (tendon(s)) → S46.00-
  • Injurymuscle (and fascia) (and tendon)triceps → S46.30-
  • Injurymuscle (and fascia) (and tendon)shoulder → S46.90-

Where it sits

  1. Chapter 19 Injury, poisoning and certain other consequences of external causes (S00-T88)
  2. S40-S49 Injuries to the shoulder and upper arm (S40-S49)
  3. S46 Injury of muscle, fascia and tendon at shoulder and upper arm level
Billable codes
216
Subdivisions
6
CC / MCC codes
18 / 0
HCC V28 codes
0
New FY2027
0
Index entries
25

Codes in S46

  1. S46.0
    Injury of muscle(s) and tendon(s) of the rotator cuff of shoulder
    Header
  2. S46.00
    Unspecified injury of muscle(s) and tendon(s) of the rotator cuff of shoulder
    Header
  3. S46.001
    Unspecified injury of muscle(s) and tendon(s) of the rotator cuff of right shoulder +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  4. S46.002
    Unspecified injury of muscle(s) and tendon(s) of the rotator cuff of left shoulder +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  5. S46.009
    Unspecified injury of muscle(s) and tendon(s) of the rotator cuff of unspecified shoulder +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  6. S46.01
    Strain of muscle(s) and tendon(s) of the rotator cuff of shoulder
    Header
  7. S46.011
    Strain of muscle(s) and tendon(s) of the rotator cuff of right shoulder +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  8. S46.012
    Strain of muscle(s) and tendon(s) of the rotator cuff of left shoulder +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  9. S46.019
    Strain of muscle(s) and tendon(s) of the rotator cuff of unspecified shoulder +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  10. S46.02
    Laceration of muscle(s) and tendon(s) of the rotator cuff of shoulder
    Header
  11. S46.021
    Laceration of muscle(s) and tendon(s) of the rotator cuff of right shoulder +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  12. S46.022
    Laceration of muscle(s) and tendon(s) of the rotator cuff of left shoulder +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  13. S46.029
    Laceration of muscle(s) and tendon(s) of the rotator cuff of unspecified shoulder +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  14. S46.09
    Other injury of muscle(s) and tendon(s) of the rotator cuff of shoulder
    Header
  15. S46.091
    Other injury of muscle(s) and tendon(s) of the rotator cuff of right shoulder +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  16. S46.092
    Other injury of muscle(s) and tendon(s) of the rotator cuff of left shoulder +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  17. S46.099
    Other injury of muscle(s) and tendon(s) of the rotator cuff of unspecified shoulder +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  18. S46.1
    Injury of muscle, fascia and tendon of long head of biceps
    Header
  19. S46.10
    Unspecified injury of muscle, fascia and tendon of long head of biceps
    Header
  20. S46.101
    Unspecified injury of muscle, fascia and tendon of long head of biceps, right arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  21. S46.102
    Unspecified injury of muscle, fascia and tendon of long head of biceps, left arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  22. S46.109
    Unspecified injury of muscle, fascia and tendon of long head of biceps, unspecified arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  23. S46.11
    Strain of muscle, fascia and tendon of long head of biceps
    Header
  24. S46.111
    Strain of muscle, fascia and tendon of long head of biceps, right arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  25. S46.112
    Strain of muscle, fascia and tendon of long head of biceps, left arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  26. S46.119
    Strain of muscle, fascia and tendon of long head of biceps, unspecified arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  27. S46.12
    Laceration of muscle, fascia and tendon of long head of biceps
    Header
  28. S46.121
    Laceration of muscle, fascia and tendon of long head of biceps, right arm +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  29. S46.122
    Laceration of muscle, fascia and tendon of long head of biceps, left arm +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  30. S46.129
    Laceration of muscle, fascia and tendon of long head of biceps, unspecified arm +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  31. S46.19
    Other injury of muscle, fascia and tendon of long head of biceps
    Header
  32. S46.191
    Other injury of muscle, fascia and tendon of long head of biceps, right arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  33. S46.192
    Other injury of muscle, fascia and tendon of long head of biceps, left arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  34. S46.199
    Other injury of muscle, fascia and tendon of long head of biceps, unspecified arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  35. S46.2
    Injury of muscle, fascia and tendon of other parts of biceps
    Header
  36. S46.20
    Unspecified injury of muscle, fascia and tendon of other parts of biceps
    Header
  37. S46.201
    Unspecified injury of muscle, fascia and tendon of other parts of biceps, right arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  38. S46.202
    Unspecified injury of muscle, fascia and tendon of other parts of biceps, left arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  39. S46.209
    Unspecified injury of muscle, fascia and tendon of other parts of biceps, unspecified arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  40. S46.21
    Strain of muscle, fascia and tendon of other parts of biceps
    Header
  41. S46.211
    Strain of muscle, fascia and tendon of other parts of biceps, right arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  42. S46.212
    Strain of muscle, fascia and tendon of other parts of biceps, left arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  43. S46.219
    Strain of muscle, fascia and tendon of other parts of biceps, unspecified arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  44. S46.22
    Laceration of muscle, fascia and tendon of other parts of biceps
    Header
  45. S46.221
    Laceration of muscle, fascia and tendon of other parts of biceps, right arm +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  46. S46.222
    Laceration of muscle, fascia and tendon of other parts of biceps, left arm +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  47. S46.229
    Laceration of muscle, fascia and tendon of other parts of biceps, unspecified arm +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  48. S46.29
    Other injury of muscle, fascia and tendon of other parts of biceps
    Header
  49. S46.291
    Other injury of muscle, fascia and tendon of other parts of biceps, right arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  50. S46.292
    Other injury of muscle, fascia and tendon of other parts of biceps, left arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  51. S46.299
    Other injury of muscle, fascia and tendon of other parts of biceps, unspecified arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  52. S46.3
    Injury of muscle, fascia and tendon of triceps
    Header
  53. S46.30
    Unspecified injury of muscle, fascia and tendon of triceps
    Header
  54. S46.301
    Unspecified injury of muscle, fascia and tendon of triceps, right arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  55. S46.302
    Unspecified injury of muscle, fascia and tendon of triceps, left arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  56. S46.309
    Unspecified injury of muscle, fascia and tendon of triceps, unspecified arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  57. S46.31
    Strain of muscle, fascia and tendon of triceps
    Header
  58. S46.311
    Strain of muscle, fascia and tendon of triceps, right arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  59. S46.312
    Strain of muscle, fascia and tendon of triceps, left arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  60. S46.319
    Strain of muscle, fascia and tendon of triceps, unspecified arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  61. S46.32
    Laceration of muscle, fascia and tendon of triceps
    Header
  62. S46.321
    Laceration of muscle, fascia and tendon of triceps, right arm +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  63. S46.322
    Laceration of muscle, fascia and tendon of triceps, left arm +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  64. S46.329
    Laceration of muscle, fascia and tendon of triceps, unspecified arm +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  65. S46.39
    Other injury of muscle, fascia and tendon of triceps
    Header
  66. S46.391
    Other injury of muscle, fascia and tendon of triceps, right arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  67. S46.392
    Other injury of muscle, fascia and tendon of triceps, left arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  68. S46.399
    Other injury of muscle, fascia and tendon of triceps, unspecified arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  69. S46.8
    Injury of other muscles, fascia and tendons at shoulder and upper arm level
    Header
  70. S46.80
    Unspecified injury of other muscles, fascia and tendons at shoulder and upper arm level
    Header
  71. S46.801
    Unspecified injury of other muscles, fascia and tendons at shoulder and upper arm level, right arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  72. S46.802
    Unspecified injury of other muscles, fascia and tendons at shoulder and upper arm level, left arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  73. S46.809
    Unspecified injury of other muscles, fascia and tendons at shoulder and upper arm level, unspecified arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  74. S46.81
    Strain of other muscles, fascia and tendons at shoulder and upper arm level
    Header
  75. S46.811
    Strain of other muscles, fascia and tendons at shoulder and upper arm level, right arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  76. S46.812
    Strain of other muscles, fascia and tendons at shoulder and upper arm level, left arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  77. S46.819
    Strain of other muscles, fascia and tendons at shoulder and upper arm level, unspecified arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  78. S46.82
    Laceration of other muscles, fascia and tendons at shoulder and upper arm level
    Header
  79. S46.821
    Laceration of other muscles, fascia and tendons at shoulder and upper arm level, right arm +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  80. S46.822
    Laceration of other muscles, fascia and tendons at shoulder and upper arm level, left arm +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  81. S46.829
    Laceration of other muscles, fascia and tendons at shoulder and upper arm level, unspecified arm +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  82. S46.89
    Other injury of other muscles, fascia and tendons at shoulder and upper arm level
    Header
  83. S46.891
    Other injury of other muscles, fascia and tendons at shoulder and upper arm level, right arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  84. S46.892
    Other injury of other muscles, fascia and tendons at shoulder and upper arm level, left arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  85. S46.899
    Other injury of other muscles, fascia and tendons at shoulder and upper arm level, unspecified arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  86. S46.9
    Injury of unspecified muscle, fascia and tendon at shoulder and upper arm level
    Header
  87. S46.90
    Unspecified injury of unspecified muscle, fascia and tendon at shoulder and upper arm level
    Header
  88. S46.901
    Unspecified injury of unspecified muscle, fascia and tendon at shoulder and upper arm level, right arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  89. S46.902
    Unspecified injury of unspecified muscle, fascia and tendon at shoulder and upper arm level, left arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  90. S46.909
    Unspecified injury of unspecified muscle, fascia and tendon at shoulder and upper arm level, unspecified arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  91. S46.91
    Strain of unspecified muscle, fascia and tendon at shoulder and upper arm level
    Header
  92. S46.911
    Strain of unspecified muscle, fascia and tendon at shoulder and upper arm level, right arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  93. S46.912
    Strain of unspecified muscle, fascia and tendon at shoulder and upper arm level, left arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  94. S46.919
    Strain of unspecified muscle, fascia and tendon at shoulder and upper arm level, unspecified arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  95. S46.92
    Laceration of unspecified muscle, fascia and tendon at shoulder and upper arm level
    Header
  96. S46.921
    Laceration of unspecified muscle, fascia and tendon at shoulder and upper arm level, right arm +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  97. S46.922
    Laceration of unspecified muscle, fascia and tendon at shoulder and upper arm level, left arm +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  98. S46.929
    Laceration of unspecified muscle, fascia and tendon at shoulder and upper arm level, unspecified arm +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  99. S46.99
    Other injury of unspecified muscle, fascia and tendon at shoulder and upper arm level
    Header
  100. S46.991
    Other injury of unspecified muscle, fascia and tendon at shoulder and upper arm level, right arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  101. S46.992
    Other injury of unspecified muscle, fascia and tendon at shoulder and upper arm level, left arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters
  102. S46.999
    Other injury of unspecified muscle, fascia and tendon at shoulder and upper arm level, unspecified arm +7th: A D S
    Needs 7th characterExempt: 2 of 3 7th characters

CC/MCC: as a secondary diagnosis, unless the principal diagnosis is on the code’s PDX exclusion list (MS-DRG v44 Appendix C; list on the code card).

Sources of each column. Rows marked +7th need a 7th character: pick one to build the full code; its code card has its own flags.

Instructions

At S46

Excludes2

  • injury of muscle, fascia and tendon at elbow (S56.-) S56
  • sprain of joints and ligaments of shoulder girdle (S43.9) S43.9

Code also

  • any associated open wound (S41.-) S41

Notes that also apply

Block S40-S49 instructions (Includes 2, Excludes2 4): printed on the block page.

Chapter 19 instructions (Notes 2, Excludes2 2, Use additional code 1): printed on the chapter 19 page.

7th characters

7th characters for S46 defined here

The appropriate 7th character is to be added to each code from category S46

7th characters for S46
7thMeaning (NCHS)
Ainitial encounter
Dsubsequent encounter
Ssequela

A code that takes a 7th character is invalid without it; the placeholder X fills a code shorter than 6 characters (Official Guidelines I.A.5). How 7th characters work.

Index entries

  • Injuryrotator cuff (muscle(s)) (tendon(s)) → S46.00-
  • Injuryrotator cuff (muscle(s)) (tendon(s))strain → S46.01-
  • Tear, torn (traumatic)rotator cuff (nontraumatic)traumatic → S46.01-
  • Injuryrotator cuff (muscle(s)) (tendon(s))laceration → S46.02-
  • Injuryrotator cuff (muscle(s)) (tendon(s))specified type NEC → S46.09-
  • Injurymuscle (and fascia) (and tendon)biceps (parts NEC) → S46.20-
  • Injurymuscle (and fascia) (and tendon)triceps → S46.30-
  • Injurymuscle (and fascia) (and tendon)shoulder → S46.90-
  • Injurymuscle (and fascia) (and tendon)biceps (parts NEC)long head → S46.10-
  • Injurymuscle (and fascia) (and tendon)biceps (parts NEC)strain → S46.21-
  • Injurymuscle (and fascia) (and tendon)biceps (parts NEC)laceration → S46.22-
  • Injurymuscle (and fascia) (and tendon)biceps (parts NEC)specified type NEC → S46.29-
  • Injurymuscle (and fascia) (and tendon)tricepsstrain → S46.31-
  • Injurymuscle (and fascia) (and tendon)tricepslaceration → S46.32-
  • Injurymuscle (and fascia) (and tendon)tricepsspecified type NEC → S46.39-
  • Injurymuscle (and fascia) (and tendon)shoulderspecified site NEC → S46.80-
  • Injurymuscle (and fascia) (and tendon)shoulderstrain → S46.91-
  • Injurymuscle (and fascia) (and tendon)shoulderlaceration → S46.92-
  • Injurymuscle (and fascia) (and tendon)shoulderspecified type NEC → S46.99-
  • Injurymuscle (and fascia) (and tendon)biceps (parts NEC)long headstrain → S46.11-
  • Injurymuscle (and fascia) (and tendon)biceps (parts NEC)long headlaceration → S46.12-
  • Injurymuscle (and fascia) (and tendon)biceps (parts NEC)long headspecified type NEC → S46.19-
  • Injurymuscle (and fascia) (and tendon)shoulderspecified site NECstrain → S46.81-
  • Injurymuscle (and fascia) (and tendon)shoulderspecified site NEClaceration → S46.82-
  • Injurymuscle (and fascia) (and tendon)shoulderspecified site NECspecified type NEC → S46.89-

NCHS Alphabetic Index. Index first, then the Tabular List.

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