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ICD-10 Guide
ICD-10 CodesS22.20

S22.20

Billable

Unspecified fracture of sternum

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

Code Description

ICD-10 S22.20 is a billable code used to indicate a diagnosis of unspecified fracture of sternum.

Key Diagnostic Point:

An unspecified fracture of the sternum refers to a break in the breastbone that does not have a specific type or location identified. This injury is often the result of blunt chest trauma, such as from a motor vehicle accident, fall, or direct impact during contact sports. The sternum, being a flat bone located in the center of the chest, plays a crucial role in protecting vital organs, including the heart and lungs. Fractures of the sternum can lead to complications such as pneumothorax (air in the pleural space), hemothorax (blood in the pleural space), and potential cardiac injuries due to the proximity of the sternum to the heart. Diagnosis typically involves imaging studies like X-rays or CT scans to assess the extent of the fracture and rule out associated injuries. Treatment may vary from conservative management, such as pain control and rest, to surgical interventions in cases of severe displacement or associated complications. Understanding the implications of a sternal fracture is essential for appropriate management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of fracture specifics
  • Potential for associated injuries requiring additional coding
  • Differentiation from other thoracic injuries
  • Need for precise imaging results to support coding

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document associated injuries
  • Misclassification of fracture type
  • Lack of imaging results in the medical record

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Detailed account of the mechanism of injury, physical examination findings, and imaging results.

Common Clinical Scenarios

Patients presenting with chest pain after trauma, difficulty breathing, or signs of shock.

Billing Considerations

Ensure that all associated injuries are documented to support additional coding.

Orthopedic Surgery

Documentation Requirements

Surgical notes detailing the type of fracture, treatment plan, and follow-up care.

Common Clinical Scenarios

Patients requiring surgical intervention for displaced sternal fractures or those with complications.

Billing Considerations

Documentation should clearly indicate the surgical approach and any complications encountered.

Coding Guidelines

Inclusion Criteria

Use S22.20 When
  • According to ICD
  • CM guidelines, S22
  • 20 should be used when the specific type of sternal fracture is not documented
  • Coders should ensure that the documentation supports the diagnosis and consider any associated injuries that may require additional codes

Exclusion Criteria

Do NOT use S22.20 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20680CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used in conjunction with sternal fracture management if joint involvement is suspected.

Documentation Requirements

Document the reason for the procedure and any findings.

Specialty Considerations

Orthopedic specialists should ensure clear documentation of joint involvement.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specificity in coding fractures, including the ability to capture associated injuries and complications more accurately, which is crucial for appropriate reimbursement and patient care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding fractures, including the ability to capture associated injuries and complications more accurately, which is crucial for appropriate reimbursement and patient care.

Reimbursement & Billing Impact

reimbursement and patient care.

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 should I document to support the use of S22.20?

Document the mechanism of injury, physical examination findings, imaging results, and any associated injuries to support the use of S22.20.