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ICD-10 Guide
ICD-10 CodesS22.080

S22.080

Billable

Wedge compression fracture of T11-T12 vertebra

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

Code Description

ICD-10 S22.080 is a billable code used to indicate a diagnosis of wedge compression fracture of t11-t12 vertebra.

Key Diagnostic Point:

A wedge compression fracture of the T11-T12 vertebra occurs when the vertebrae in the thoracic spine sustain a fracture that causes them to collapse or become wedge-shaped. This type of fracture is often the result of trauma, such as a fall or motor vehicle accident, and can lead to significant pain, reduced mobility, and potential complications such as spinal cord injury. The thoracic spine is particularly vulnerable to such injuries due to its structural characteristics and the forces exerted during trauma. Patients may present with symptoms including localized back pain, difficulty breathing, and neurological deficits if the spinal cord is affected. Diagnosis typically involves imaging studies such as X-rays, CT scans, or MRIs to assess the extent of the fracture and any associated injuries. Treatment may vary from conservative management, including pain control and physical therapy, to surgical interventions like vertebroplasty or spinal fusion, depending on the severity of the fracture and the patient's overall health status.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of vertebral fractures (compression vs. burst)
  • Identifying associated injuries (e.g., rib fractures, 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
  • Misclassification of fracture type
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Management of acute thoracic spine injuries, surgical interventions for unstable fractures.

Billing Considerations

Ensure clear documentation of fracture type and treatment rationale.

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Evaluation of trauma patients with suspected spinal injuries.

Billing Considerations

Accurate documentation of neurological status and mechanism of injury is crucial.

Coding Guidelines

Inclusion Criteria

Use S22.080 When
  • Follow ICD
  • CM guidelines for coding fractures, including specificity regarding the type of fracture and any associated injuries
  • Ensure compliance with documentation standards for trauma cases

Exclusion Criteria

Do NOT use S22.080 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Vertebroplasty

Clinical Scenario

Used for stabilization of wedge compression fractures.

Documentation Requirements

Operative report detailing the procedure and indications.

Specialty Considerations

Orthopedic surgeons must document the need for surgical intervention.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of spinal injuries, improving the accuracy of data collection and reimbursement processes. S22.080 provides a clear classification for wedge compression fractures, facilitating better patient management and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of spinal injuries, improving the accuracy of data collection and reimbursement processes. S22.080 provides a clear classification for wedge compression fractures, facilitating better patient management and outcomes.

Reimbursement & Billing Impact

reimbursement processes. S22.080 provides a clear classification for wedge compression fractures, facilitating better patient management and outcomes.

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 cause of a wedge compression fracture?

Wedge compression fractures are primarily caused by trauma, such as falls or accidents, but can also occur due to conditions like osteoporosis.

How is a wedge compression fracture diagnosed?

Diagnosis is typically made through imaging studies, including X-rays, CT scans, or MRIs, which reveal the characteristic collapse of the vertebra.

What are the treatment options for a wedge compression fracture?

Treatment may include conservative management with pain control and physical therapy, or surgical options such as vertebroplasty or spinal fusion, depending on the fracture's severity.