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ICD-10 Guide
ICD-10 CodesS22.001

S22.001

Billable

Stable burst fracture of unspecified thoracic vertebra

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/23/2025

Code Description

ICD-10 S22.001 is a billable code used to indicate a diagnosis of stable burst fracture of unspecified thoracic vertebra.

Key Diagnostic Point:

A stable burst fracture of the thoracic vertebra occurs when a vertebra is subjected to significant axial loading, resulting in a fracture that does not compromise the spinal canal or lead to neurological deficits. This type of fracture is characterized by the vertebral body being crushed and the fragments remaining in place, thus maintaining spinal stability. Patients may present with localized pain, tenderness, and limited mobility. The thoracic spine is particularly vulnerable to trauma from falls, motor vehicle accidents, or sports injuries. Associated conditions may include rib fractures, pneumothorax, or hemothorax, which can complicate the clinical picture. Diagnosis typically involves imaging studies such as X-rays or CT scans to assess the extent of the fracture and rule out other injuries. Treatment may range from conservative management, including pain control and physical therapy, to surgical interventions in more severe cases. Understanding the implications of this fracture type is crucial for effective management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of fracture type and stability
  • Need for precise imaging reports to confirm diagnosis
  • Differentiation from other thoracic injuries such as rib fractures
  • Potential for associated conditions like pneumothorax or hemothorax

Audit Risk Factors

  • Inadequate documentation of fracture stability
  • Failure to document associated injuries
  • Misclassification of fracture type
  • Lack of imaging reports in the medical record

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, clinical notes describing the mechanism of injury, and treatment plans.

Common Clinical Scenarios

Patients presenting with back pain after trauma, requiring imaging and potential surgical evaluation.

Billing Considerations

Ensure clear documentation of fracture stability and any associated injuries.

Emergency Medicine

Documentation Requirements

Comprehensive trauma assessments, including vital signs, mechanism of injury, and initial imaging results.

Common Clinical Scenarios

Patients with acute chest pain and suspected thoracic injuries following trauma.

Billing Considerations

Document all findings thoroughly to support coding and potential surgical referrals.

Coding Guidelines

Inclusion Criteria

Use S22.001 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture type, stability, and any associated conditions
  • Include relevant imaging findings and clinical assessments

Exclusion Criteria

Do NOT use S22.001 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22554CPT Code

Percutaneous vertebroplasty

Clinical Scenario

Used in cases where stabilization of the vertebra is necessary.

Documentation Requirements

Document the indication for the procedure and imaging findings.

Specialty Considerations

Orthopedic specialists should ensure clear documentation of the fracture type and stability.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows for more specific coding of thoracic injuries, improving the accuracy of patient records and facilitating better treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 allows for more specific coding of thoracic injuries, improving the accuracy of patient records and facilitating better treatment planning.

Reimbursement & Billing Impact

reimbursement process.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between a stable and unstable burst fracture?

A stable burst fracture maintains spinal alignment and does not compromise the spinal canal, while an unstable burst fracture may lead to neurological deficits and requires more intensive management.