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ICD-10 Guide
ICD-10 CodesS22.31

S22.31

Billable

Fracture of one rib, right side

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

Code Description

ICD-10 S22.31 is a billable code used to indicate a diagnosis of fracture of one rib, right side.

Key Diagnostic Point:

A fracture of one rib on the right side typically occurs due to blunt trauma to the chest, such as from a fall, motor vehicle accident, or sports injury. Rib fractures can lead to significant pain, especially during breathing, coughing, or movement. The right side of the rib cage houses vital organs, including the right lung and liver, making it crucial to assess for complications such as pneumothorax (air in the pleural space) or hemothorax (blood in the pleural space). These complications can arise if the fractured rib punctures the pleura or injures surrounding blood vessels. Patients may present with localized tenderness, crepitus, and difficulty breathing. Diagnosis is typically confirmed through imaging studies such as chest X-rays or CT scans. Treatment often involves pain management, respiratory therapy, and monitoring for complications. In severe cases, surgical intervention may be necessary to stabilize the rib or address associated injuries. Accurate coding is essential for proper reimbursement and tracking of healthcare outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between simple and complex rib fractures
  • Identifying associated injuries (e.g., pneumothorax, hemothorax)
  • Documenting the mechanism of injury accurately
  • Understanding the implications of right-sided versus left-sided fractures

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document associated complications
  • Misclassification of the fracture type
  • Inconsistent coding of follow-up visits

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Detailed account of the mechanism of injury, physical examination findings, and imaging results.

Common Clinical Scenarios

Patients presenting with chest pain after trauma, difficulty breathing, or signs of respiratory distress.

Billing Considerations

Ensure documentation reflects the urgency of the situation and any immediate interventions performed.

Orthopedic Surgery

Documentation Requirements

Comprehensive surgical notes if intervention is performed, including pre-operative assessments and post-operative care.

Common Clinical Scenarios

Patients requiring surgical stabilization of rib fractures or those with complications such as flail chest.

Billing Considerations

Document any associated injuries and the rationale for surgical intervention.

Coding Guidelines

Inclusion Criteria

Use S22.31 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture type, location, and any associated complications
  • Include details about the mechanism of injury and any relevant imaging findings

Exclusion Criteria

Do NOT use S22.31 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20680CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used in cases where rib fractures lead to complications requiring drainage.

Documentation Requirements

Document the indication for the procedure and any imaging guidance used.

Specialty Considerations

Orthopedic specialists may need to provide detailed operative notes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of rib fractures, improving the granularity of data collected for patient outcomes and treatment efficacy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of rib fractures, improving the granularity of data collected for patient outcomes and treatment efficacy.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of rib fractures, improving the granularity of data collected for patient outcomes and treatment efficacy.

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 rib fractures?

Rib fractures are primarily caused by blunt trauma, which can occur from falls, vehicle accidents, or direct blows to the chest.

How can rib fractures lead to complications?

Rib fractures can puncture the pleura, leading to pneumothorax or hemothorax, which can compromise respiratory function and require immediate medical intervention.