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ICD-10 Guide
ICD-10 CodesS22.051

S22.051

Billable

Stable burst fracture of T5-T6 vertebra

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

Code Description

ICD-10 S22.051 is a billable code used to indicate a diagnosis of stable burst fracture of t5-t6 vertebra.

Key Diagnostic Point:

A stable burst fracture of the T5-T6 vertebra occurs when the vertebrae in the thoracic spine are subjected to significant axial loading, leading to a fracture that radiates outward from the center of the vertebra. This type of fracture is characterized by the preservation of spinal stability, meaning that the spinal cord and surrounding structures are not compromised. Patients may present with localized pain, tenderness, and limited mobility in the thoracic region. The mechanism of injury is often associated with high-energy trauma, such as falls or motor vehicle accidents. In addition to the fracture, clinicians must assess for potential complications such as rib fractures, pneumothorax, hemothorax, and cardiac injuries, which can occur due to the proximity of the thoracic cavity to the heart and lungs. Management typically involves conservative treatment, including pain management and physical therapy, although surgical intervention may be necessary in cases of instability or neurological compromise. Accurate coding is essential for proper reimbursement and tracking of patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between stable and unstable fractures
  • Assessing associated injuries (e.g., pneumothorax, rib fractures)
  • Understanding the mechanism of injury
  • Documentation of clinical findings and imaging results

Audit Risk Factors

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

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed imaging reports, surgical notes, and follow-up assessments.

Common Clinical Scenarios

Management of thoracic spine fractures, surgical interventions for instability.

Billing Considerations

Ensure clear documentation of fracture type and stability.

Emergency Medicine

Documentation Requirements

Comprehensive trauma assessments, imaging results, and initial management plans.

Common Clinical Scenarios

Evaluation of trauma patients with suspected thoracic injuries.

Billing Considerations

Document all associated injuries and the mechanism of injury clearly.

Coding Guidelines

Inclusion Criteria

Use S22.051 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture type, stability, and any associated injuries
  • Include imaging results and clinical assessments to support the diagnosis

Exclusion Criteria

Do NOT use S22.051 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Percutaneous vertebroplasty

Clinical Scenario

Used in cases where stabilization is required for burst fractures.

Documentation Requirements

Document indications for vertebroplasty and imaging findings.

Specialty Considerations

Orthopedic surgeons should ensure clear documentation of the fracture type.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows for more specific coding of thoracic spine injuries, improving the accuracy of patient records and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 allows for more specific coding of thoracic spine injuries, improving the accuracy of patient records and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 difference between stable and unstable burst fractures?

Stable burst fractures do not compromise spinal stability or neurological function, while unstable fractures may lead to spinal cord injury or require surgical intervention.