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ICD-10 Guide
ICD-10 CodesS22.089

S22.089

Billable

Unspecified fracture of T11-T12 vertebra

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

Code Description

ICD-10 S22.089 is a billable code used to indicate a diagnosis of unspecified fracture of t11-t12 vertebra.

Key Diagnostic Point:

The S22.089 code is used to classify an unspecified fracture of the T11-T12 vertebrae, which are located in the thoracic region of the spine. Fractures in this area can occur due to various mechanisms of injury, including trauma from falls, motor vehicle accidents, or sports injuries. These fractures can lead to significant complications, including spinal cord injury, which may result in neurological deficits. Patients may present with symptoms such as back pain, difficulty in movement, and neurological signs depending on the severity of the fracture. The management of T11-T12 fractures often involves a multidisciplinary approach, including pain management, physical therapy, and possibly surgical intervention if there is instability or neurological compromise. It is crucial for healthcare providers to document the mechanism of injury, clinical findings, and any associated injuries, such as rib fractures or pneumothorax, to ensure accurate coding and appropriate treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of fractures
  • Potential for associated injuries (e.g., rib fractures, pneumothorax)
  • Need for detailed documentation of mechanism of injury
  • Differentiation from other thoracic spine injuries

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document associated injuries
  • Misclassification of fracture type or location
  • Lack of clarity in clinical notes regarding treatment decisions

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging reports, and follow-up assessments are essential for accurate coding.

Common Clinical Scenarios

Fractures requiring surgical intervention, conservative management of stable fractures, and post-operative care.

Billing Considerations

Documentation must clearly indicate the type of fracture and any associated injuries to ensure appropriate coding.

Emergency Medicine

Documentation Requirements

Thorough documentation of initial assessment, imaging results, and treatment provided in the emergency setting.

Common Clinical Scenarios

Patients presenting with acute back pain following trauma, evaluation for potential spinal cord injury.

Billing Considerations

Accurate coding requires clear documentation of the mechanism of injury and any immediate interventions performed.

Coding Guidelines

Inclusion Criteria

Use S22.089 When
  • According to ICD
  • 10 coding guidelines, S22
  • 089 should be used when the fracture is confirmed but not specified further
  • Coders should ensure that the documentation supports the diagnosis and that any associated injuries are coded appropriately

Exclusion Criteria

Do NOT use S22.089 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Percutaneous vertebroplasty

Clinical Scenario

Used for stabilization of vertebral fractures in patients with osteoporosis.

Documentation Requirements

Operative report detailing the procedure and indications.

Specialty Considerations

Orthopedic surgeons must document the necessity for the procedure based on imaging findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fractures, improving the ability to capture the complexity of thoracic injuries. This has implications for treatment planning and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the ability to capture the complexity of thoracic injuries. This has implications for treatment planning and reimbursement.

Reimbursement & Billing Impact

reimbursement.

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 significance of coding S22.089?

Coding S22.089 accurately reflects the patient's condition and ensures appropriate treatment and reimbursement. It is essential for tracking outcomes and managing care for patients with thoracic spine injuries.