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ICD-10 Guide
ICD-10 CodesS22.088

S22.088

Billable

Other fracture of T11-T12 vertebra

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

Code Description

ICD-10 S22.088 is a billable code used to indicate a diagnosis of other fracture of t11-t12 vertebra.

Key Diagnostic Point:

The S22.088 code refers to fractures occurring in the T11 and T12 vertebrae, which are part of the thoracic spine. These fractures can result from various mechanisms, including trauma from falls, motor vehicle accidents, or sports injuries. The thoracic spine is crucial for protecting the spinal cord and supporting the rib cage, and fractures in this area can lead to significant complications. Patients may present with acute pain, limited mobility, and neurological deficits depending on the severity and type of fracture. Associated injuries may include rib fractures, pneumothorax, hemothorax, and cardiac injuries, which can complicate the clinical picture. Management often involves pain control, stabilization, and possibly surgical intervention, such as vertebroplasty or spinal fusion, depending on the fracture's stability and the patient's overall health. Accurate coding is essential for proper treatment reimbursement and tracking of outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and associated injuries
  • Need for precise documentation of trauma mechanism
  • Potential for concurrent rib fractures and thoracic injuries
  • Differentiation from other thoracic spine codes

Audit Risk Factors

  • Inadequate documentation of fracture type and location
  • Failure to document associated injuries like pneumothorax or hemothorax
  • Misclassification of fracture severity
  • Lack of clarity on the mechanism of injury

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Fractures due to falls, sports injuries, or trauma requiring surgical intervention.

Billing Considerations

Ensure documentation reflects the type of fracture and any surgical procedures performed.

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with acute chest pain and suspected thoracic injuries.

Billing Considerations

Document all associated injuries and the mechanism of injury for accurate coding.

Coding Guidelines

Inclusion Criteria

Use S22.088 When
  • Follow the official ICD
  • CM coding guidelines, ensuring to document the specific vertebrae involved and any associated injuries
  • Include details about the mechanism of injury and treatment provided

Exclusion Criteria

Do NOT use S22.088 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Vertebroplasty

Clinical Scenario

Used for stabilization of T11-T12 fractures.

Documentation Requirements

Surgical notes detailing the procedure and indications.

Specialty Considerations

Orthopedic documentation must include pre-operative assessments.

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 patient records and reimbursement processes. S22.088 provides granularity that was not available in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of patient records and reimbursement processes. S22.088 provides granularity that was not available in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. S22.088 provides granularity that was not available in ICD-9.

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 T11-T12 fractures?

Common causes include falls, motor vehicle accidents, and sports injuries. Osteoporosis can also contribute to fractures in older adults.