S22.042A Unstable burst fracture of fourth thoracic vertebra, initial encounter for closed fracture

Billable ICD-10-CM code, FY2026.

Built from S22.042 with 7th character A (initial encounter for closed fracture).

Applies from S22 Fracture of rib(s), sternum and thoracic spine

Includes

• fracture of thoracic neural arch
• fracture of thoracic spinous process
• fracture of thoracic transverse process
• fracture of thoracic vertebra
• fracture of thoracic vertebral arch

Excludes1 (never code together)

• transection of thorax (S28.1)

Excludes2 (not included here)

• fracture of clavicle (S42.0-)
• fracture of scapula (S42.1-)

Code also

• , if applicable, any associated condition such as:
• injury of intrathoracic organ (S27.-)
• spinal cord injury (S24.0-, S24.1-)
• traumatic hemopneumothorax (S27.2)
• traumatic hemothorax (S27.1-)
• traumatic pneumothorax (S27.0)

7th character note

• The appropriate 7th character is to be added to each code from category S22

Notes

• A fracture not indicated as displaced or nondisplaced should be coded to displaced
• A fracture not indicated as open or closed should be coded to closed

7th character required

• 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 (HCC)

• CMS-HCC V28: HCC 401 — Vertebral Fractures without Spinal Cord Injury
• CMS-HCC V22: HCC 169 — Vertebral Fractures without Spinal Cord Injury
• ESRD V24: HCC 169

Code annotations containing back-references to S22.042A

Back-references to S22.0

• Type 1 Excludes: M48.4 Fatigue fracture of vertebra ("traumatic fracture of vertebrae (S12.0-S12.3-, S22.0-, S32.0-)")
• Type 2 Excludes: S23.1 Subluxation and dislocation of thoracic vertebra ("fracture of thoracic vertebrae (S22.0-)")
• Code Also: S24 Injury of nerves and spinal cord at thorax level ("fracture of thoracic vertebra (S22.0-)")
• Code Also: S34 Injury of lumbar and sacral spinal cord and nerves at abdomen, lower back and pelvis level ("fracture of vertebra (S22.0-, S32.0-)")
• Use Additional: S38.1 Crushing injury of abdomen, lower back, and pelvis ("fracture of thoracic or lumbar spine and pelvis (S22.0-, S32.-)")

Back-references to S22

• Type 1 Excludes: M48.5 Collapsed vertebra, not elsewhere classified ("traumatic fracture of vertebra (S12.-, S22.-, S32.-)")
• Type 1 Excludes: M84.3 Stress fracture ("traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)")
• Type 1 Excludes: M84.4 Pathological fracture, not elsewhere classified ("traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)")

Diagnosis Index entries for S22.042A

• Fracture, traumatic (abduction) (adduction) (separation) › thorax (bony) › vertebra (displaced) › fourth › burst (stable) › unstable

Nearby codes

• S22.041D Stable burst fracture of fourth thoracic vertebra, subsequent encounter for fracture with routine healing
• S22.041G Stable burst fracture of fourth thoracic vertebra, subsequent encounter for fracture with delayed healing
• S22.041K Stable burst fracture of fourth thoracic vertebra, subsequent encounter for fracture with nonunion
• S22.041S Stable burst fracture of fourth thoracic vertebra, sequela
• S22.042 Unstable burst fracture of fourth thoracic vertebra
• S22.042A Unstable burst fracture of fourth thoracic vertebra, initial encounter for closed fracture (this code)
• S22.042B Unstable burst fracture of fourth thoracic vertebra, initial encounter for open fracture
• S22.042D Unstable burst fracture of fourth thoracic vertebra, subsequent encounter for fracture with routine healing
• S22.042G Unstable burst fracture of fourth thoracic vertebra, subsequent encounter for fracture with delayed healing
• S22.042K Unstable burst fracture of fourth thoracic vertebra, subsequent encounter for fracture with nonunion
• S22.042S Unstable burst fracture of fourth thoracic vertebra, sequela