ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 S22

Non-Billable Header

Fracture of rib(s), sternum and thoracic spine

S22
Block
0
Synonyms
0
LCDs
2
Payer Policies
0
Linked CPTs

About ICD-10-CM S22

ICD-10-CM code S22 represents Fracture of rib(s), sternum and thoracic spine. This is a non-billable header code in the Injury, Poisoning, and External Causes chapter (block S22). The 2026 edition of ICD-10-CM S22 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.

Coding Tips for S22

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Injury chapter (S00-T88): 7th character extension required

Injury codes require a 7th character: A (initial encounter, active treatment), D (subsequent, healing/recovery), S (sequela, late effect of original injury). Codes with fewer than 6 characters need the placeholder X to bring them to 6 characters before adding the 7th. Wrong or missing 7th character is the #1 cause of injury claim denials.

Type 1 Excludes

Pure excludes, these codes can never be coded together with S22. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • transection of thorax (S28.1)

Type 2 Excludes

Not included here, the excluded code is not part of S22, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

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

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

Coding Notes

Code Also

  • , if applicable, any associated condition such as:
  • injury of intrathoracic organ (S27.-)
  • spinal cord injury (S24.0-, S24.1-)
  • traumatic hemopneumothorax (S27.2)
  • traumatic hemothorax (S27.1-)
  • traumatic pneumothorax (S27.0)

Seven Chr Note

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

Medicare LCD Coverage for S22

Local Coverage Determinations (LCDs) from CMS MACs that list S22 as a covered diagnosis.

No Medicare LCDs reference S22 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing S22.

2 policies

2 Cigna

Breast Reconstruction Following Mastectomy or Lumpectomy - (0178)
Policy ID: MM_0178
Drug-Eluting Devices for Use Following Endoscopic Sinus Surgery - (0481)
Policy ID: MM_0481

CPT Codes Commonly Billed with S22

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for S22

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

ICD-10 S22, Billing FAQ

Is ICD-10 code S22 billable? +

No, S22 is a non-billable header code. Use a more specific child code from block S22 when submitting claims.

What codes are Type 1 Excludes for S22? +

Type 1 Excludes (never code together with S22): transection of thorax (S28.1)

What codes are Type 2 Excludes for S22? +

Type 2 Excludes (may be coded together when both conditions exist): fracture of clavicle (S42.0-); fracture of scapula (S42.1-)

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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