DxCodebookFY2027 · Oct 1, 2026 – Sep 30, 2027

Category · FY2027

S22 Fracture of rib(s), sternum and thoracic spine

  • Header · not billable
  • Codes take a 7th character

S22 is not billable. The category heads 354 billable codes in FY2027, grouped under 6 subdivisions. Its codes take a 7th character, so none is complete with fewer than 7 characters.

Index → code

  • Flailchest → S22.5
  • Fracture, traumatic (abduction) (adduction) (separation)rib → S22.3-
  • Fracture, traumatic (abduction) (adduction) (separation)sternum → S22.20

Where it sits

  1. Chapter 19 Injury, poisoning and certain other consequences of external causes (S00-T88)
  2. S20-S29 Injuries to the thorax (S20-S29)
  3. S22 Fracture of rib(s), sternum and thoracic spine
Billable codes
354
Subdivisions
6
CC / MCC codes
117 / 60
HCC V28 codes
90
New FY2027
0
Index entries
83

Codes in S22

  1. S22.0
    Fracture of thoracic vertebra
    Header
  2. S22.00
    Fracture of unspecified thoracic vertebra
    Header
  3. S22.000
    Wedge compression fracture of unspecified thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  4. S22.001
    Stable burst fracture of unspecified thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  5. S22.002
    Unstable burst fracture of unspecified thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  6. S22.008
    Other fracture of unspecified thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  7. S22.009
    Unspecified fracture of unspecified thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  8. S22.01
    Fracture of first thoracic vertebra
    Header
  9. S22.010
    Wedge compression fracture of first thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  10. S22.011
    Stable burst fracture of first thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  11. S22.012
    Unstable burst fracture of first thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  12. S22.018
    Other fracture of first thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  13. S22.019
    Unspecified fracture of first thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  14. S22.02
    Fracture of second thoracic vertebra
    Header
  15. S22.020
    Wedge compression fracture of second thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  16. S22.021
    Stable burst fracture of second thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  17. S22.022
    Unstable burst fracture of second thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  18. S22.028
    Other fracture of second thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  19. S22.029
    Unspecified fracture of second thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  20. S22.03
    Fracture of third thoracic vertebra
    Header
  21. S22.030
    Wedge compression fracture of third thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  22. S22.031
    Stable burst fracture of third thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  23. S22.032
    Unstable burst fracture of third thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  24. S22.038
    Other fracture of third thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  25. S22.039
    Unspecified fracture of third thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  26. S22.04
    Fracture of fourth thoracic vertebra
    Header
  27. S22.040
    Wedge compression fracture of fourth thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  28. S22.041
    Stable burst fracture of fourth thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  29. S22.042
    Unstable burst fracture of fourth thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  30. S22.048
    Other fracture of fourth thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  31. S22.049
    Unspecified fracture of fourth thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  32. S22.05
    Fracture of T5-T6 vertebra
    Header
  33. S22.050
    Wedge compression fracture of T5-T6 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  34. S22.051
    Stable burst fracture of T5-T6 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  35. S22.052
    Unstable burst fracture of T5-T6 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  36. S22.058
    Other fracture of T5-T6 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  37. S22.059
    Unspecified fracture of T5-T6 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  38. S22.06
    Fracture of T7-T8 vertebra
    Header
  39. S22.060
    Wedge compression fracture of T7-T8 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  40. S22.061
    Stable burst fracture of T7-T8 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  41. S22.062
    Unstable burst fracture of T7-T8 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  42. S22.068
    Other fracture of T7-T8 thoracic vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  43. S22.069
    Unspecified fracture of T7-T8 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  44. S22.07
    Fracture of T9-T10 vertebra
    Header
  45. S22.070
    Wedge compression fracture of T9-T10 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  46. S22.071
    Stable burst fracture of T9-T10 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  47. S22.072
    Unstable burst fracture of T9-T10 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  48. S22.078
    Other fracture of T9-T10 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  49. S22.079
    Unspecified fracture of T9-T10 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  50. S22.08
    Fracture of T11-T12 vertebra
    Header
  51. S22.080
    Wedge compression fracture of T11-T12 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  52. S22.081
    Stable burst fracture of T11-T12 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  53. S22.082
    Unstable burst fracture of T11-T12 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  54. S22.088
    Other fracture of T11-T12 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  55. S22.089
    Unspecified fracture of T11-T12 vertebra +7th: A B D G K S
    Needs 7th characterCC A K MCC B401 (some 7th characters)Exempt: 4 of 6 7th characters
  56. S22.2
    Fracture of sternum
    Header
  57. S22.20
    Unspecified fracture of sternum +7th: A B D G K S
    Needs 7th characterCC A K MCC BExempt: 4 of 6 7th characters
  58. S22.21
    Fracture of manubrium +7th: A B D G K S
    Needs 7th characterCC A K MCC BExempt: 4 of 6 7th characters
  59. S22.22
    Fracture of body of sternum +7th: A B D G K S
    Needs 7th characterCC A K MCC BExempt: 4 of 6 7th characters
  60. S22.23
    Sternal manubrial dissociation +7th: A B D G K S
    Needs 7th characterCC A K MCC BExempt: 4 of 6 7th characters
  61. S22.24
    Fracture of xiphoid process +7th: A B D G K S
    Needs 7th characterCC A K MCC BExempt: 4 of 6 7th characters
  62. S22.3
    Fracture of one rib
    Header
  63. S22.31
    Fracture of one rib, right side +7th: A B D G K S
    Needs 7th characterCC A K MCC BExempt: 4 of 6 7th characters
  64. S22.32
    Fracture of one rib, left side +7th: A B D G K S
    Needs 7th characterCC A K MCC BExempt: 4 of 6 7th characters
  65. S22.39
    Fracture of one rib, unspecified side +7th: A B D G K S
    Needs 7th characterCC A K MCC BExempt: 4 of 6 7th characters
  66. S22.4
    Multiple fractures of ribs
    Header
    Inclusion terms 1, Excludes1 1

    Inclusion terms

    • Fractures of two or more ribs

    Excludes1

    • flail chest (S22.5-) S22.5
  67. S22.41
    Multiple fractures of ribs, right side +7th: A B D G K S
    Needs 7th characterCC A K MCC BExempt: 4 of 6 7th characters
  68. S22.42
    Multiple fractures of ribs, left side +7th: A B D G K S
    Needs 7th characterCC A K MCC BExempt: 4 of 6 7th characters
  69. S22.43
    Multiple fractures of ribs, bilateral +7th: A B D G K S
    Needs 7th characterCC A K MCC BExempt: 4 of 6 7th characters
  70. S22.49
    Multiple fractures of ribs, unspecified side +7th: A B D G K S
    Needs 7th characterCC A K MCC BExempt: 4 of 6 7th characters
  71. S22.5
    Flail chest +7th: A B D G K S
    Needs 7th characterCC K MCC A BExempt: 4 of 6 7th characters
  72. S22.9
    Fracture of bony thorax, part unspecified +7th: A B D G K S
    Needs 7th characterCC A K MCC BExempt: 4 of 6 7th characters

CC/MCC: as a secondary diagnosis, unless the principal diagnosis is on the code’s PDX exclusion list (MS-DRG v44 Appendix C; list on the code card).

Sources of each column. Rows marked +7th need a 7th character: pick one to build the full code; its code card has its own flags.

Instructions

At S22

Notes

  • A fracture not indicated as displaced or nondisplaced should be coded to displaced
  • A fracture not indicated as open or closed should be coded to closed

Includes

  • fracture of thoracic neural arch
  • fracture of thoracic spinous process
  • fracture of thoracic transverse process
  • fracture of thoracic vertebra
  • fracture of thoracic vertebral arch

Excludes1

  • transection of thorax (S28.1) S28.1

Excludes2

  • fracture of clavicle (S42.0-) S42.0
  • fracture of scapula (S42.1-) S42.1

Code first

  • , if applicable, spinal cord injury (S24.0-, S24.1-) S24.0 S24.1

Code also

  • , if applicable, any associated condition such as:
  • injury of intrathoracic organ (S27.-) S27
  • traumatic hemopneumothorax (S27.2) S27.2
  • traumatic hemothorax (S27.1-) S27.1
  • traumatic pneumothorax (S27.0) S27.0

Notes that also apply

Block S20-S29 instructions (Includes 3, Excludes2 11): printed on the block page.

Chapter 19 instructions (Notes 2, Excludes2 2, Use additional code 1): printed on the chapter 19 page.

7th characters

7th characters for S22 defined here

The appropriate 7th character is to be added to each code from category S22

7th characters for S22
7thMeaning (NCHS)
Ainitial encounter for closed fracture
Binitial encounter for open fracture
Dsubsequent encounter for fracture with routine healing
Gsubsequent encounter for fracture with delayed healing
Ksubsequent encounter for fracture with nonunion
Ssequela

A code that takes a 7th character is invalid without it; the placeholder X fills a code shorter than 6 characters (Official Guidelines I.A.5). How 7th characters work.

Index entries

  • Fracture, traumatic (abduction) (adduction) (separation)sternum → S22.20
  • Fracture, traumatic (abduction) (adduction) (separation)manubrium (sterni) → S22.21
  • Fracture, traumatic (abduction) (adduction) (separation)xiphisternum, xiphoid (process) → S22.24
  • Fracture, traumatic (abduction) (adduction) (separation)rib → S22.3-
  • Flailchest → S22.5
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony) → S22.9
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced) → S22.009
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)sternum → S22.20
  • Fracture, traumatic (abduction) (adduction) (separation)sternummanubrium → S22.21
  • Fracture, traumatic (abduction) (adduction) (separation)sternumbody → S22.22
  • Fracture, traumatic (abduction) (adduction) (separation)manubrium (sterni)dissociation from sternum → S22.23
  • Fracture, traumatic (abduction) (adduction) (separation)sternumxiphoid (process) → S22.24
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)rib → S22.3-
  • Fracture, traumatic (abduction) (adduction) (separation)ribmultiple → S22.4-
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)wedge compression → S22.000
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)burst (stable) → S22.001
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)nondisplaced → S22.001
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)specified type NEC → S22.008
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)first → S22.019
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)second → S22.029
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)third → S22.039
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)fourth → S22.049
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)fifth → S22.059
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)sixth → S22.059
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)eighth → S22.069
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)seventh → S22.069
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)ninth → S22.079
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)tenth → S22.079
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)eleventh → S22.089
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)twelfth → S22.089
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)sternummanubrium → S22.21
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)sternumbody → S22.22
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)sternumxiphoid process → S22.24
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)ribmultiple → S22.4-
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)burst (stable)unstable → S22.002
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)firstwedge compression → S22.010
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)firstburst (stable) → S22.011
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)firstspecified type NEC → S22.018
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)secondwedge compression → S22.020
  • Fracture, traumatic (abduction) (adduction) (separation)thorax (bony)vertebra (displaced)secondburst (stable) → S22.021

43 more, longer entries are not listed; the search box finds them by word.

NCHS Alphabetic Index. Index first, then the Tabular List.

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