S22.5 vs S28.0
S22.5 and S28.0 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on S28.0
flail chest (S22.5)
S22.5
Flail chest
Not billable
- Chapter 19
- Injury, poisoning and certain other consequences of external causes
- Section
- S20-S29
Indexed under
- Flail › chest
S28.0
Crushed chest
Not billable
- Chapter 19
- Injury, poisoning and certain other consequences of external causes
- Section
- S20-S29
Indexed under
- Asphyxia, asphyxiation › crushing (by)
- Crush, crushed, crushing › chest
- Asphyxia, asphyxiation › traumatic › due to › crushed chest (by)
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027