S22.011B — Stable burst fracture of first thoracic vertebra, initial encounter for open fracture
S22.011B is a billable, specific ICD-10-CM code for stable burst fracture of first thoracic vertebra, initial encounter for open fracture. It is valid for submission on a claim.
7th character "B" — initial encounter for open fracture
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
Risk adjustment
S22.011B risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 401 Vertebral Fractures without Spinal Cord Injury0.522 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
S22.011B is named in 11 Medicare coverage policies — 11 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56900Billing and Coding: Immunizations
- A57132Billing and Coding: Bone Mass Measurement
Related codes at this level
Codes that share S22.011. If S22.011B is not quite right, the correct code is usually one of these.
- S22.011AStable burst fracture of first thoracic vertebra, initial encounter for closed fracture
- S22.011DStable burst fracture of first thoracic vertebra, subsequent encounter for fracture with routine healing
- S22.011GStable burst fracture of first thoracic vertebra, subsequent encounter for fracture with delayed healing
- S22.011KStable burst fracture of first thoracic vertebra, subsequent encounter for fracture with nonunion
- S22.011SStable burst fracture of first thoracic vertebra, sequela
Questions about S22.011B
- Is S22.011B a billable ICD-10-CM code?
- Yes. S22.011B is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S22.011B 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).