Is S22.011 a billable ICD-10-CM code?

No. S22.011 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does S22.011 sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the thorax (S20-S29).

What cannot be coded together with S22.011?

S22.011 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S22.011 (S22) and apply to it just the same.

S22.011

S22.011 — Stable burst fracture of first thoracic vertebra

Non-billable headerICD-10-CM

S22.011 is a non-billable header ICD-10-CM code for stable burst fracture of first thoracic vertebra. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

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

A: initial encounter for closed fracture
B: initial encounter for open fracture
D: subsequent encounter for fracture with routine healing
G: subsequent encounter for fracture with delayed healing
K: subsequent encounter for fracture with nonunion
S: sequela

Excludes1 inherited from the categories above S22.011

These are not written on S22.011, but they bind it: a note on a category applies to every code beneath it. Billing S22.011 with anything listed here is a denial.

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

transection of thorax (S28.1)

Excludes2 inherited from the categories above S22.011

Also inherited, and the opposite of Excludes1: these conditions are not part of S22.011, but a patient can have both, so you may code both.

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

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

Other codes that can never be billed with S22.011

These codes carry an Excludes1 note pointing at S22.011. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S22.011 alone.

M48.5Collapsed vertebra, not elsewhere classified
M84.3Stress fracture
M84.4Pathological fracture, not elsewhere classified

Risk adjustment

S22.011 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

How S22.011 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to S22.011.

Fracture, traumatic›thorax›vertebra›first›burst(stable)

Code history

S22.011 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead S22.011

6 child codes. Green means billable.

Related codes at this level

Codes that share S22.01. If S22.011 is not quite right, the correct code is usually one of these.

Questions about S22.011

Is S22.011 a billable ICD-10-CM code?: No. S22.011 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does S22.011 sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the thorax (S20-S29).
What cannot be coded together with S22.011?: S22.011 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S22.011 (S22) and apply to it just the same.