S22.31XB

S22.31XB: Fracture of one rib, right side, initial encounter for open fracture

Billable / specific codeICD-10-CMright

S22.31XB is a billable, specific ICD-10-CM code for fracture of one rib, right side, initial encounter for open fracture. It is valid for submission on a claim.

Check S22.31XB with the rest of the claim: free scrubber

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

Excludes1 inherited from the categories above S22.31XB

A category’s note binds every code beneath it.

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

transection of thorax (S28.1)

Excludes2 inherited from the categories above S22.31XB

Not part of this code, but both may be coded when both are present.

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 S22.31XB

Their own Excludes1 notes name this code, so the conflict is not listed above.

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

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

S22.31XB is named in 7 Medicare coverage policies: 7 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
A56900Billing and Coding: Immunizations
A57205Billing and Coding: Oximetry Services
A57311Billing and Coding: Physical Therapy - Home Health

Code history

Unchanged in every release from FY2024 to FY2027.