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v1.0.0
ICD-10 Guide
ICD-10 CodesS22.0

S22.0

Billable

Fracture of thoracic vertebra

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

Code Description

ICD-10 S22.0 is a billable code used to indicate a diagnosis of fracture of thoracic vertebra.

Key Diagnostic Point:

A fracture of the thoracic vertebra refers to a break in one of the twelve vertebrae located in the thoracic region of the spine, which is situated between the cervical and lumbar regions. These fractures can occur due to various mechanisms, including trauma from falls, motor vehicle accidents, or sports injuries. Patients may present with symptoms such as localized pain, tenderness, and limited mobility. In severe cases, spinal cord injury may occur, leading to neurological deficits. Associated conditions may include rib fractures, pneumothorax, hemothorax, and cardiac injuries, which can complicate the clinical picture. Diagnosis typically involves imaging studies such as X-rays, CT scans, or MRIs to assess the extent of the fracture and any potential complications. Treatment options vary based on the severity of the fracture and may include conservative management with pain control and physical therapy or surgical interventions such as vertebroplasty or spinal fusion. Accurate coding is essential for proper reimbursement and tracking of patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of thoracic vertebral fractures (e.g., compression vs. burst fractures)
  • Identifying associated injuries such as rib fractures or pneumothorax
  • Documenting the mechanism of injury accurately
  • Understanding the implications of spinal cord involvement

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document associated injuries or complications
  • Incorrect coding of the type of fracture
  • Lack of clarity in treatment plans or surgical interventions

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and post-operative care notes are essential.

Common Clinical Scenarios

Fractures resulting from trauma requiring surgical intervention, such as spinal fusion or stabilization.

Billing Considerations

Ensure documentation reflects the type of fracture and any neurological assessments.

Emergency Medicine

Documentation Requirements

Thorough documentation of initial assessment, imaging results, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with acute back pain following trauma, with potential for associated rib or lung injuries.

Billing Considerations

Document all findings related to the thoracic region, including any signs of pneumothorax or hemothorax.

Coding Guidelines

Inclusion Criteria

Use S22.0 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture type, associated injuries, and treatment
  • Include any relevant external cause codes to describe the mechanism of injury

Exclusion Criteria

Do NOT use S22.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Vertebroplasty

Clinical Scenario

Used for stabilization of vertebral fractures.

Documentation Requirements

Operative report detailing the procedure and indications.

Specialty Considerations

Orthopedic surgeons must document the type of fracture and any pre-existing conditions.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of thoracic vertebra fractures, improving the granularity of data for research and reimbursement. It emphasizes the importance of detailed documentation to capture the complexity of these injuries.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of thoracic vertebra fractures, improving the granularity of data for research and reimbursement. It emphasizes the importance of detailed documentation to capture the complexity of these injuries.

Reimbursement & Billing Impact

reimbursement. It emphasizes the importance of detailed documentation to capture the complexity of these injuries.

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 thoracic vertebra fractures?

Common causes include falls, motor vehicle accidents, sports injuries, and osteoporosis-related fractures.

How do I document associated injuries with thoracic vertebra fractures?

Document all findings from imaging studies, physical examinations, and any surgical interventions performed to ensure accurate coding.