S26.022S — Major laceration of heart with hemopericardium, sequela
S26.022S is a billable, specific ICD-10-CM code for major laceration of heart with hemopericardium, sequela. It is valid for submission on a claim.
7th character "S" — sequela
The appropriate 7th character is to be added to each code from category S26
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Laceration of heart with penetration of multiple heart chambers
Other codes that can never be billed with S26.022S
These codes carry an Excludes1 note pointing at S26.022S. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S26.022S alone.
Risk adjustment
S26.022S 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
S26.022S is named in 8 Medicare coverage policies — 8 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56625Billing and Coding: Echocardiography
- A56625Billing and Coding: Echocardiography
Code history
S26.022S has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share S26.022. If S26.022S is not quite right, the correct code is usually one of these.
Questions about S26.022S
- Is S26.022S a billable ICD-10-CM code?
- Yes. S26.022S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S26.022S 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).