2025 ICD-10-CM code S22
Fracture of rib(s), sternum and thoracic spine. This code encompasses fractures of the ribs, sternum (breastbone), and thoracic spine, occurring with or without neurological involvement.
Medical necessity is established by the presence of fractures confirmed through imaging, along with associated symptoms and functional limitations. The need for specific treatments (conservative vs. surgical) is determined based on the fracture severity, stability, and neurological involvement.
Physicians diagnose this condition through patient history, physical examination, neurological tests (evaluating muscle strength, sensation, and reflexes), and imaging techniques (X-rays, CT scans, and MRI) to determine the extent of the injury. Treatment varies depending on the severity and can include rest, pain medication, supplemental oxygen, steroids, deep breathing exercises, physical therapy, and in some cases, surgery (like sternal fixation).
In simple words: A fracture of the ribs, sternum (breastbone), and thoracic spine involves a break in these bones. It can happen with or without damage to the nervous system. This injury is often caused by trauma like a car accident, fall, or sports injury, but can also be due to conditions like osteoporosis or cancer. Symptoms may include chest pain, shortness of breath, rapid heartbeat, swelling, stiffness, numbness, tingling, and possibly nerve injury leading to partial or complete paralysis.
Fracture of rib(s), sternum and thoracic spine. 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. Code also, if applicable, any associated: injury of intrathoracic organ (S27.-), spinal cord injury (S24.0-, S24.1-). 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. Excludes1: transection of thorax (S28.1). Excludes2: fracture of clavicle (S42.0-), fracture of scapula (S42.1-).
Example 1: A patient involved in a high-speed car accident presents with severe chest pain and shortness of breath. Imaging reveals fractures in multiple ribs, the sternum, and the T5 vertebra., An elderly patient with osteoporosis falls at home and experiences sudden, sharp pain in their mid-back. X-rays confirm fractures in the thoracic spine and several ribs, along with a minor sternal fracture., An athlete sustains a direct blow to the chest during a contact sport, leading to a fractured sternum and ribs. Further examination shows a small fracture in the thoracic spine without neurological damage.
Documentation should include details of the traumatic event (if applicable), physical examination findings (including neurological assessment), imaging reports (X-ray, CT, MRI), and any associated injuries like spinal cord damage or internal organ injuries.
** The ribs and sternum contribute to the stability of the thoracic spine. The degree of sternal displacement can indicate the severity of intrathoracic injuries. For fractures with neurological injury, accurate documentation of neurological findings is crucial.
- Specialties:Orthopedic Surgery, Trauma Surgery, Emergency Medicine, Neurosurgery (if spinal cord injury is present)
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Office, Outpatient Hospital