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ICD-10 Guide
ICD-10 CodesS22.4

S22.4

Billable

Multiple fractures of ribs

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

Code Description

ICD-10 S22.4 is a billable code used to indicate a diagnosis of multiple fractures of ribs.

Key Diagnostic Point:

Multiple rib fractures typically occur due to blunt chest trauma, such as from motor vehicle accidents, falls, or sports injuries. These fractures can lead to significant complications, including pneumothorax (air in the pleural space), hemothorax (blood in the pleural space), and potential cardiac injuries due to the proximity of the ribs to the heart. The clinical presentation may include severe chest pain, difficulty breathing, and decreased lung capacity. Diagnosis is often confirmed through imaging studies such as chest X-rays or CT scans, which can reveal the extent of rib involvement and associated injuries. Management may involve pain control, respiratory support, and in some cases, surgical intervention to repair damaged structures or drain fluid collections. The presence of multiple rib fractures increases the risk of complications, necessitating careful monitoring and management in a clinical setting.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in the number and location of fractures
  • Potential for associated injuries (e.g., pneumothorax, hemothorax)
  • Need for precise documentation of fracture types and locations
  • Differentiation from single rib fractures or other thoracic injuries

Audit Risk Factors

  • Inadequate documentation of the number and type of fractures
  • Failure to document associated injuries (e.g., pneumothorax, hemothorax)
  • Misclassification of rib fractures as other thoracic injuries
  • Lack of clarity on the mechanism of injury

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with chest trauma after accidents or falls, requiring immediate assessment and intervention.

Billing Considerations

Accurate documentation of vital signs and any immediate interventions performed is crucial for coding.

Thoracic Surgery

Documentation Requirements

Comprehensive surgical notes detailing the procedure performed, indications for surgery, and post-operative care.

Common Clinical Scenarios

Patients requiring surgical intervention for rib stabilization or drainage of hemothorax.

Billing Considerations

Documentation must clearly outline the surgical approach and any complications encountered.

Coding Guidelines

Inclusion Criteria

Use S22.4 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the number of fractures and any associated injuries
  • Include details on the mechanism of injury and any surgical interventions performed

Exclusion Criteria

Do NOT use S22.4 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 patient with rib fractures requires drainage of a hemothorax.

Documentation Requirements

Document the indication for the procedure and the amount of fluid drained.

Specialty Considerations

Ensure that the procedure is clearly linked to the diagnosis of rib fractures.

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. S22.4 provides a clear distinction for multiple rib fractures, which was less defined in ICD-9.

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. S22.4 provides a clear distinction for multiple rib fractures, which was less defined in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. S22.4 provides a clear distinction for multiple rib fractures, which was less defined in ICD-9.

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 documentation needed for coding S22.4?

The primary documentation includes the mechanism of injury, imaging results confirming multiple rib fractures, and any associated complications such as pneumothorax or hemothorax.