Is S22.088A a billable ICD-10-CM code?

Yes. S22.088A is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S22.088A 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).

S22.088A

S22.088A — Other fracture of T11-T12 vertebra, initial encounter for closed fracture

Billable / specific codeICD-10-CM

S22.088A is a billable, specific ICD-10-CM code for other fracture of t11-t12 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

S22.088A 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

S22.088A is named in 9 Medicare coverage policies — 9 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
A57132Billing and Coding: Bone Mass Measurement
A57132Billing and Coding: Bone Mass Measurement
A57205Billing and Coding: Oximetry Services

Related codes at this level

Codes that share S22.088. If S22.088A is not quite right, the correct code is usually one of these.

Questions about S22.088A

Is S22.088A a billable ICD-10-CM code?: Yes. S22.088A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S22.088A 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).