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ICD-10 Guide
ICD-10 CodesS22.3

S22.3

Billable

Fracture of one rib

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

Code Description

ICD-10 S22.3 is a billable code used to indicate a diagnosis of fracture of one rib.

Key Diagnostic Point:

A fracture of one rib is a common injury that typically results from blunt trauma to the chest, such as from a fall, motor vehicle accident, or direct impact. Rib fractures can lead to significant pain, respiratory difficulties, and complications such as pneumothorax (air in the pleural space) or hemothorax (blood in the pleural space). The fracture may be classified as simple or complicated, depending on whether it disrupts the pleura or injures surrounding structures. Patients often present with localized pain, tenderness, and difficulty breathing, particularly with deep breaths or coughing. Diagnosis is usually confirmed through imaging studies, such as chest X-rays or CT scans, which can also help identify associated injuries. Management typically involves pain control, respiratory support, and monitoring for complications. In severe cases, surgical intervention may be necessary to repair the rib or address associated injuries. Understanding the implications of rib fractures is crucial for effective treatment and coding, as they can significantly impact patient outcomes and healthcare costs.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation quality regarding the mechanism of injury
  • Potential for associated injuries (e.g., pneumothorax, hemothorax)
  • Need for precise imaging results to confirm diagnosis
  • Differentiation from other thoracic injuries

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document associated complications
  • Misclassification of the type of rib fracture
  • Inconsistent coding of follow-up visits

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 respiratory distress.

Billing Considerations

Ensure documentation captures any immediate interventions or complications, such as pneumothorax.

Orthopedic Surgery

Documentation Requirements

Comprehensive notes on the fracture type, treatment plan, and any surgical interventions performed.

Common Clinical Scenarios

Patients requiring surgical fixation of rib fractures or those with chronic pain from non-union.

Billing Considerations

Document any pre-existing conditions that may affect healing or surgical outcomes.

Coding Guidelines

Inclusion Criteria

Use S22.3 When
  • According to ICD
  • 10 guidelines, S22
  • 3 should be used for a single rib fracture without mention of complications
  • Coders must ensure that the documentation supports the diagnosis and that any associated injuries are coded separately

Exclusion Criteria

Do NOT use S22.3 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 when a rib fracture leads to joint complications requiring aspiration.

Documentation Requirements

Document the reason for the procedure and any imaging findings.

Specialty Considerations

Orthopedic specialists should ensure clear linkage between the rib fracture and the need for the procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of rib fractures, improving the accuracy of data collection and reimbursement processes. S22.3 provides a clear distinction for single rib fractures, which aids in clinical management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of rib fractures, improving the accuracy of data collection and reimbursement processes. S22.3 provides a clear distinction for single rib fractures, which aids in clinical management and research.

Reimbursement & Billing Impact

reimbursement processes. S22.3 provides a clear distinction for single rib fractures, which aids in clinical management and research.

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 primary treatment for a single rib fracture?

The primary treatment for a single rib fracture typically involves pain management, respiratory exercises, and monitoring for complications. Surgical intervention may be considered in cases of severe displacement or associated injuries.