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ICD-10 Guide
ICD-10 CodesS22.038

S22.038

Billable

Other fracture of third thoracic vertebra

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

Code Description

ICD-10 S22.038 is a billable code used to indicate a diagnosis of other fracture of third thoracic vertebra.

Key Diagnostic Point:

The S22.038 code refers to fractures of the third thoracic vertebra that do not fall into more specific categories. These fractures can occur due to various mechanisms of injury, including high-energy trauma such as motor vehicle accidents, falls from heights, or sports injuries. The thoracic spine is particularly vulnerable due to its location and the forces exerted during trauma. Patients may present with symptoms such as localized pain, neurological deficits, or even respiratory distress if the fracture impacts surrounding structures. Complications can include spinal cord injury, pneumothorax, or hemothorax, particularly in cases of significant chest trauma. Accurate diagnosis often requires imaging studies such as X-rays, CT scans, or MRIs to assess the extent of the fracture and any associated injuries. Treatment may involve conservative management with pain control and physical therapy or surgical intervention in more severe cases to stabilize the spine and prevent further complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and associated injuries
  • Need for precise documentation of mechanism of injury
  • Potential for co-existing conditions such as pneumothorax or hemothorax
  • Differentiation from other thoracic vertebra fractures

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document associated injuries such as pneumothorax
  • Incorrect coding of fracture type or location
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and follow-up notes.

Common Clinical Scenarios

Fracture stabilization procedures, post-operative care for thoracic spine surgery.

Billing Considerations

Ensure documentation reflects the specific type of fracture and any surgical interventions performed.

Emergency Medicine

Documentation Requirements

Comprehensive trauma assessments, imaging results, and initial treatment plans.

Common Clinical Scenarios

Management of acute thoracic trauma, including fractures and associated injuries.

Billing Considerations

Document all findings and interventions to support the diagnosis and any subsequent admissions.

Coding Guidelines

Inclusion Criteria

Use S22.038 When
  • Follow ICD
  • CM guidelines for coding fractures, including specificity in the type and location of the fracture
  • Ensure to document any associated injuries or complications

Exclusion Criteria

Do NOT use S22.038 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Percutaneous vertebroplasty

Clinical Scenario

Used for stabilization of vertebral fractures.

Documentation Requirements

Operative report detailing the procedure and indications.

Specialty Considerations

Orthopedic documentation must reflect the need for intervention.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding fractures, including those of the thoracic vertebrae. This has improved the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding fractures, including those of the thoracic vertebrae. This has improved the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 are the common causes of S22.038 fractures?

Common causes include high-energy trauma such as motor vehicle accidents, falls from heights, and sports injuries.

How do I differentiate S22.038 from other thoracic vertebra fractures?

S22.038 is used for fractures that do not fit into more specific categories, while other codes may specify the type of fracture (e.g., compression, burst).