Is S22.012A a billable ICD-10-CM code?

Yes. S22.012A is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S22.012A 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).

S22.012A

S22.012A — Unstable burst fracture of first thoracic vertebra, initial encounter for closed fracture

Billable / specific codeICD-10-CM

S22.012A is a billable, specific ICD-10-CM code for unstable burst fracture of first thoracic vertebra, initial encounter for closed fracture. It is valid for submission on a claim.

7th character "A" — initial encounter for closed 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

S22.012A 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

S22.012A is named in 5 Medicare coverage policies — 5 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
A57205Billing and Coding: Oximetry Services
A57311Billing and Coding: Physical Therapy - Home Health
A57604Billing and Coding: Intraoperative Neurophysiological Testing

Related codes at this level

Codes that share S22.012. If S22.012A is not quite right, the correct code is usually one of these.

Questions about S22.012A

Is S22.012A a billable ICD-10-CM code?: Yes. S22.012A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S22.012A 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).