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S43.1 ICD-10-CM Code: Subluxation and dislocation of acromioclavicular joint

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FY 2026 Apr update / Injury, poisoning and certain other consequences of external causes (S00-T88) / Injuries to the shoulder and upper arm (S40-S49)

S43.1

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Subluxation and dislocation of acromioclavicular joint

Subluxation and dislocation of acromioclavicular joint

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
S43Dislocation and sprain of joints and ligaments of shoulder girdle
S43.1Subluxation and dislocation of acromioclavicular joint

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for S43.1 in this effective period.

Excludes 2

Official
  • strain of muscle, fascia and tendon of shoulder and upper arm (S46.-)

Related Child Codes

Official
S43.10Unspecified dislocation of acromioclavicular joint
S43.11Subluxation of acromioclavicular joint
S43.12Dislocation of acromioclavicular joint, 100%-200% displacement
S43.13Dislocation of acromioclavicular joint, greater than 200% displacement
S43.14Inferior dislocation of acromioclavicular joint

Includes

Official
  • avulsion of joint or ligament of shoulder girdle
  • laceration of cartilage, joint or ligament of shoulder girdle
  • sprain of cartilage, joint or ligament of shoulder girdle
  • traumatic hemarthrosis of joint or ligament of shoulder girdle
  • traumatic rupture of joint or ligament of shoulder girdle

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for S43.1 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for S43.1 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for S43.1 in this effective period.

Code Also

Official
  • any associated open wound

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

S43.1 is the ICD-10-CM diagnosis code for subluxation and dislocation of acromioclavicular joint. S43.1 sits in the ICD-10-CM chapter for injury, poisoning and certain other consequences of external causes (s00-t88), within the section covering injuries to the shoulder and upper arm (s40-s49).

Header codes like S43.1 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at S43.1's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for S43.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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