ICD-10 Coding for Fracture Ribs(S22.31XA, S22.43XD)
Complete ICD-10-CM coding and documentation guide for Fracture Ribs. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Fracture Ribs
S22.3-S22.5Primary Range
Fracture of ribs, sternum and thoracic spine
This range includes codes for fractures of single and multiple ribs, as well as flail chest.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S22.31XA | Fracture of one rib, right side, initial encounter for closed fracture | Use when a patient presents with a closed fracture of a single rib on the right side. |
|
| S22.43XD | Multiple fractures of ribs, bilateral, subsequent encounter | Use for subsequent encounters for bilateral rib fractures. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for rib fracture
Essential facts and insights about Fracture Ribs
Primary ICD-10-CM Codes for fracture ribs
Decision Criteria
clinical Criteria
- Presence of fracture on imaging
documentation Criteria
- Clear documentation of fracture type and laterality
Applicable To
- Closed fracture of one rib on the right side
Excludes
- Open fracture of one rib (S22.31XB)
Clinical Validation Requirements
- CT or X-ray confirming fracture
- Physical examination showing tenderness or deformity
Code-Specific Risks
- Incorrect laterality documentation
- Failure to specify open vs closed fracture
Coding Notes
- Ensure documentation specifies laterality and fracture type (open vs closed).
S22.43XD - Multiple fractures of ribs, bilateral, subsequent encounter
Use for subsequent encounters for bilateral rib fractures.
Applicable To
- Bilateral rib fractures
Excludes
- Flail chest (S22.5XXA)
Clinical Validation Requirements
- CT showing multiple bilateral rib fractures
- Physical examination with bilateral chest tenderness
Coding Notes
Ensure encounter type and bilateral nature are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Fracture Ribs to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S22.31XA.
Impact
Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always document the side of the body affected., Use templates that prompt for laterality.
Impact
Reimbursement: Potential denial of claims due to incorrect coding., Compliance: Non-compliance with coding standards., Data Quality: Inaccurate patient records and statistics.
Mitigation Strategy
Verify and document the correct side of the rib fracture.
Impact
Misclassification of initial vs subsequent encounters.
Mitigation Strategy
Train staff on encounter type documentation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Fracture Ribs, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Fracture Ribs
Use these documentation templates to ensure complete and accurate documentation for Fracture Ribs. These templates include all required elements for proper coding and billing.
Initial encounter for rib fracture
Specialty: Emergency MedicineRequired Elements
- Mechanism of injury
- Location and laterality
- Fracture type (open/closed)
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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