Excludes1 pair
S22.5- vs S28.0-
S22.5 and S28.0 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
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
- Crush, crushed, crushing › chest
- Asphyxia, asphyxiation › traumatic › due to › crushed chest
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