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ICD-10 Guide
ICD-10 CodesS22.00

S22.00

Billable

Fracture of unspecified thoracic vertebra

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

Code Description

ICD-10 S22.00 is a billable code used to indicate a diagnosis of fracture of unspecified thoracic vertebra.

Key Diagnostic Point:

A fracture of an unspecified thoracic vertebra typically occurs due to trauma, such as falls, motor vehicle accidents, or sports injuries. This type of fracture can lead to significant pain, limited mobility, and potential neurological complications if the spinal cord is affected. The thoracic spine consists of 12 vertebrae (T1-T12), and fractures can vary in severity from simple hairline fractures to complex burst fractures. Symptoms may include localized pain, tenderness, and in severe cases, neurological deficits. Diagnosis is primarily through imaging studies such as X-rays, CT scans, or MRIs, which help determine the fracture's location and severity. Treatment options may range from conservative management, including pain control and physical therapy, to surgical interventions in cases of instability or neurological compromise. Understanding the implications of thoracic vertebral fractures is crucial, as they can also be associated with other thoracic injuries, including rib fractures, pneumothorax, and hemothorax, necessitating a comprehensive evaluation and management plan.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and severity
  • Potential for associated injuries (e.g., rib fractures, pneumothorax)
  • Need for precise documentation of trauma mechanism
  • Differentiation from other thoracic spine codes

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to document associated injuries
  • Misclassification of fracture type
  • Lack of clarity on treatment plan

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, treatment plans, and follow-up notes.

Common Clinical Scenarios

Fractures resulting from falls, sports injuries, or vehicular accidents.

Billing Considerations

Documentation must specify the fracture type and any associated injuries.

Emergency Medicine

Documentation Requirements

Initial assessment notes, imaging results, and treatment provided in the emergency setting.

Common Clinical Scenarios

Patients presenting with acute back pain after trauma.

Billing Considerations

Timely documentation is critical for accurate coding and billing.

Coding Guidelines

Inclusion Criteria

Use S22.00 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the fracture's nature and any associated injuries

Exclusion Criteria

Do NOT use S22.00 When
  • Exclude codes for specific vertebrae fractures unless specified

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Percutaneous vertebroplasty

Clinical Scenario

Used for stabilization of vertebral fractures.

Documentation Requirements

Pre-operative imaging and post-operative follow-up notes.

Specialty Considerations

Orthopedic specialists must document the necessity of 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 thoracic vertebra fractures, improving the accuracy of patient records and treatment plans. S22.00 provides a general code for unspecified fractures, which can be useful in cases where detailed information is not available at the time of coding.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of thoracic vertebra fractures, improving the accuracy of patient records and treatment plans. S22.00 provides a general code for unspecified fractures, which can be useful in cases where detailed information is not available at the time of coding.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of thoracic vertebra fractures, improving the accuracy of patient records and treatment plans. S22.00 provides a general code for unspecified fractures, which can be useful in cases where detailed information is not available at the time of coding.

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

When should I use S22.00 instead of a specific thoracic vertebra code?

Use S22.00 when the specific vertebra involved in the fracture is not documented or known. If the specific vertebra is identified, use the corresponding specific code.