Chapter XIX
Injury, poisoning and certain other consequences of external causes
(S00-T98)

Injuries to the shoulder and upper arm
(S40-S49)

Includes: injuries of:
· axilla
· scapular region
Excludes: bilateral involvement of shoulder and upper arm ( T00-T07 )
burns and corrosions ( T20-T32 )
frostbite ( T33-T35 )
injuries of:
· arm, level unspecified ( T10-T11 )
· elbow ( S50-S59 )
insect bite or sting, venomous ( T63.4 )

S40 Superficial injury of shoulder and upper arm
S40.0 Contusion of shoulder and upper arm
S40.7 Multiple superficial injuries of shoulder and upper arm
S40.8 Other superficial injuries of shoulder and upper arm
S40.9 Superficial injury of shoulder and upper arm, unspecified

S41 Open wound of shoulder and upper arm
Excludes: traumatic amputation of shoulder and upper arm ( S48.- )
S41.0 Open wound of shoulder
S41.1 Open wound of upper arm
S41.7 Multiple open wounds of shoulder and upper arm
S41.8 Open wound of other and unspecified parts of shoulder girdle

S42 Fracture of shoulder and upper arm
The following subdivisions are provided for optional use in a supplementary character position where it is not possible or not desired to use multiple coding to identify fracture and open wound; a fracture not indicated as closed or open should be classified as closed.
0 closed
1 open
S42.0 Fracture of clavicle
Clavicle:
· acromial end
· shaft
Collar bone
S42.1 Fracture of scapula
Acromial process
Acromion (process)
Scapula (body)(glenoid cavity)(neck)
Shoulder blade
S42.2 Fracture of upper end of humerus
Anatomical neck
Great tuberosity
Proximal end
Surgical neck
Upper epiphysis
S42.3 Fracture of shaft of humerus
Humerus NOS
Upper arm NOS
S42.4 Fracture of lower end of humerus
Articular process
Distal end
External condyle
Intercondylar
Internal epicondyle
Lower epiphysis
Supracondylar
Excludes: fracture of elbow NOS ( S52.0 )
S42.7 Multiple fractures of clavicle, scapula and humerus
S42.8 Fracture of other parts of shoulder and upper arm
S42.9 Fracture of shoulder girdle, part unspecified
Fracture of shoulder NOS

S43 Dislocation, sprain and strain of joints and ligaments of shoulder girdle
S43.0 Dislocation of shoulder joint
Glenohumeral joint
S43.1 Dislocation of acromioclavicular joint
S43.2 Dislocation of sternoclavicular joint
S43.3 Dislocation of other and unspecified parts of shoulder girdle
Dislocation of shoulder girdle NOS
S43.4 Sprain and strain of shoulder joint
Coracohumeral (ligament)
Rotator cuff capsule
S43.5 Sprain and strain of acromioclavicular joint
Acromioclavicular ligament
S43.6 Sprain and strain of sternoclavicular joint
S43.7 Sprain and strain of other and unspecified parts of shoulder girdle
Sprain and strain of shoulder girdle NOS

S44 Injury of nerves at shoulder and upper arm level
Excludes: injury of brachial plexus ( S14.3 )
S44.0 Injury of ulnar nerve at upper arm level
Excludes: ulnar nerve NOS ( S54.0 )
S44.1 Injury of median nerve at upper arm level
Excludes: median nerve NOS ( S54.1 )
S44.2 Injury of radial nerve at upper arm level
Excludes: radial nerve NOS ( S54.2 )
S44.3 Injury of axillary nerve
S44.4 Injury of musculocutaneous nerve
S44.5 Injury of cutaneous sensory nerve at shoulder and upper arm level
S44.7 Injury of multiple nerves at shoulder and upper arm level
S44.8 Injury of other nerves at shoulder and upper arm level
S44.9 Injury of unspecified nerve at shoulder and upper arm level

S45 Injury of blood vessels at shoulder and upper arm level
Excludes: injury of subclavian:
· artery ( S25.1 )
· vein ( S25.3 )
S45.0 Injury of axillary artery
S45.1 Injury of brachial artery
S45.2 Injury of axillary or brachial vein
S45.3 Injury of superficial vein at shoulder and upper arm level
S45.7 Injury of multiple blood vessels at shoulder and upper arm level
S45.8 Injury of other blood vessels at shoulder and upper arm level
S45.9 Injury of unspecified blood vessel at shoulder and upper arm level

S46 Injury of muscle and tendon at shoulder and upper arm level
Excludes: injury of muscle and tendon at or below elbow ( S56.- )
S46.0 Injury of tendon of the rotator cuff of shoulder
S46.1 Injury of muscle and tendon of long head of biceps
S46.2 Injury of muscle and tendon of other parts of biceps
S46.3 Injury of muscle and tendon of triceps
S46.7 Injury of multiple muscles and tendons at shoulder and upper arm level
S46.8 Injury of other muscles and tendons at shoulder and upper arm level
S46.9 Injury of unspecified muscle and tendon at shoulder and upper arm level

S47 Crushing injury of shoulder and upper arm
Excludes: crushing injury of elbow ( S57.0 )

S48 Traumatic amputation of shoulder and upper arm
Excludes: traumatic amputation:
· at elbow level ( S58.0 )
· of arm, level unspecified ( T11.6 )
S48.0 Traumatic amputation at shoulder joint
S48.1 Traumatic amputation at level between shoulder and elbow
S48.9 Traumatic amputation of shoulder and upper arm, level unspecified

S49 Other and unspecified injuries of shoulder and upper arm
S49.7 Multiple injuries of shoulder and upper arm
Injuries classifiable to more than one of the categories S40-S48
S49.8 Other specified injuries of shoulder and upper arm
S49.9 Unspecified injury of shoulder and upper arm