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ICD-10 Guide
ICD-10 CodesS22.059

S22.059

Billable

Unspecified fracture of T5-T6 vertebra

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

Code Description

ICD-10 S22.059 is a billable code used to indicate a diagnosis of unspecified fracture of t5-t6 vertebra.

Key Diagnostic Point:

The S22.059 code refers to an unspecified fracture of the T5 and T6 vertebrae, which are located in the thoracic region of the spine. This type of fracture can occur due to various mechanisms of injury, including trauma from falls, motor vehicle accidents, or sports injuries. The thoracic spine is critical for protecting the spinal cord and supporting the rib cage, and fractures in this area can lead to significant complications. Patients may present with symptoms such as localized pain, tenderness, and limited mobility. In severe cases, associated injuries such as rib fractures, pneumothorax, or hemothorax may occur, necessitating further evaluation and intervention. The management of these fractures often involves pain control, stabilization, and in some cases, surgical intervention to prevent further complications. Accurate coding is essential for appropriate treatment planning and reimbursement, as well as for tracking outcomes in patients with thoracic spine injuries.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and associated injuries
  • Need for detailed imaging reports to confirm fracture type
  • Potential for complications such as pneumothorax or hemothorax
  • Differentiation from other thoracic spine injuries

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document associated injuries
  • Lack of imaging reports to support the diagnosis
  • Inconsistent clinical findings in the medical record

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, clinical notes on pain and mobility, and surgical reports if applicable.

Common Clinical Scenarios

Fractures due to falls, sports injuries, or motor vehicle accidents.

Billing Considerations

Ensure accurate documentation of fracture type and any associated injuries for proper coding.

Emergency Medicine

Documentation Requirements

Comprehensive assessment notes, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with chest trauma and potential spinal injuries.

Billing Considerations

Document all findings related to chest trauma, including rib fractures and pneumothorax.

Coding Guidelines

Inclusion Criteria

Use S22.059 When
  • According to ICD
  • 10 coding guidelines, S22
  • 059 should be used when the specific fracture type is not documented
  • Coders must ensure that all relevant clinical information is captured to support the diagnosis and any associated conditions

Exclusion Criteria

Do NOT use S22.059 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Percutaneous vertebroplasty

Clinical Scenario

Used for stabilization of vertebral fractures.

Documentation Requirements

Document indications for procedure and imaging results.

Specialty Considerations

Orthopedic specialists should ensure proper coding based on the type of fracture.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of data collection and reimbursement processes. S22.059 provides a means to capture unspecified fractures, but coders must ensure thorough documentation to support its use.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of data collection and reimbursement processes. S22.059 provides a means to capture unspecified fractures, but coders must ensure thorough documentation to support its use.

Reimbursement & Billing Impact

reimbursement processes. S22.059 provides a means to capture unspecified fractures, but coders must ensure thorough documentation to support its use.

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 should I document to support the use of S22.059?

Document the mechanism of injury, clinical findings, imaging results, and any associated injuries to support the use of this code.