S22.5XXA
S22.5XXA — Flail chest, initial encounter for closed fracture
Billable / specific codeICD-10-CM
S22.5XXA is a billable, specific ICD-10-CM code for flail chest, 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
S22.5XXA 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.
Medicare coverage
S22.5XXA 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
- A56625Billing and Coding: Echocardiography
- A56625Billing and Coding: Echocardiography
- A56625Billing and Coding: Echocardiography
Related codes at this level
Codes that share S22.5. If S22.5XXA is not quite right, the correct code is usually one of these.
- S22.5XXBFlail chest, initial encounter for open fracture
- S22.5XXDFlail chest, subsequent encounter for fracture with routine healing
- S22.5XXGFlail chest, subsequent encounter for fracture with delayed healing
- S22.5XXKFlail chest, subsequent encounter for fracture with nonunion
- S22.5XXSFlail chest, sequela
Questions about S22.5XXA
- Is S22.5XXA a billable ICD-10-CM code?
- Yes. S22.5XXA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S22.5XXA 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).