S03.43XS — Sprain of jaw, bilateral, sequela
S03.43XS is a billable, specific ICD-10-CM code for sprain of jaw, bilateral, sequela. It is valid for submission on a claim.
7th character "S" — sequela
The appropriate 7th character is to be added to each code from category S03
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S03.43XS does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
S03.43XS is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56729Billing and Coding: Magnetic Resonance Imaging of the Head and Neck
- A57079Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
Code history
S03.43XS has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share S03.43. If S03.43XS is not quite right, the correct code is usually one of these.
Questions about S03.43XS
- Is S03.43XS a billable ICD-10-CM code?
- Yes. S03.43XS is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S03.43XS sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the head (S00-S09).