S22.49XK — Multiple fractures of ribs, unspecified side, subsequent encounter for fracture with nonunion
Is S22.49XK billable?
Yes, but S22.49XK will trip a Medicare edit. S22.49XK is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S22.49XK under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.
More specific alternatives
S22.49XK at a glance
| Code | S22.49XK |
|---|---|
| Description | Multiple fractures of ribs, unspecified side, subsequent encounter for fracture with nonunion |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "K" | subsequent encounter for fracture with nonunion |
What does the 7th character "K" mean in S22.49XK?
In S22.49XK, the 7th character K means subsequent encounter for fracture with nonunion. The 7th character is required for S22.49XK to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to S22.49XK?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S22.49XK directly.
A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.
Which MS-DRGs does S22.49XK group to?
S22.49XK sits in MDC 08 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 564Other Musculoskeletal System and Connective Tissue Diagnoses with MCCmedical
- 565Other Musculoskeletal System and Connective Tissue Diagnoses with CCmedical
- 566Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCCmedical
As a secondary diagnosis, S22.49XK is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is S22.49XK listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S22.4, the nearest indexed parent of S22.49XK. Use them to find the family, then select the specific code.
- Fracture, traumatic › rib › multiple (abduction) (adduction) (separation)
- Fracture, traumatic › thorax › rib › multiple (abduction) (adduction) (separation)
Excludes1 — never code together — inherited from S22
The conditions below can never be reported together with S22.49XK on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- transection of thorax (S28.1)
Excludes1 — never code together — inherited from S22.4
The conditions below can never be reported together with S22.49XK on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- flail chest (S22.5-)
Code first — inherited from S22
The underlying condition below must be sequenced before S22.49XK. S22.49XK describes a manifestation and cannot be the principal or first-listed diagnosis.
Use additional code — inherited from Chapter 19
Report an additional code alongside S22.49XK to fully describe the condition. S22.49XK is sequenced first.
- code to identify any retained foreign body, if applicable (Z18.-)
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of S22.49XK, but a patient may have both at the same time. When documentation supports it, S22.49XK and the excluded code may both be reported.
Excludes2 — not included here — inherited from S20-S29
The conditions below are not part of S22.49XK, but a patient may have both at the same time. When documentation supports it, S22.49XK and the excluded code may both be reported.
- burns and corrosions (T20-T32)
- effects of foreign body in bronchus (T17.5)
- effects of foreign body in esophagus (T18.1)
- effects of foreign body in lung (T17.8)
- effects of foreign body in trachea (T17.4)
- frostbite (T33-T34)
- injuries of axilla
- injuries of clavicle
- injuries of scapular region
- injuries of shoulder
- insect bite or sting, venomous (T63.4)
Excludes2 — not included here — inherited from S22
The conditions below are not part of S22.49XK, but a patient may have both at the same time. When documentation supports it, S22.49XK and the excluded code may both be reported.
Code also — inherited from S22
Two codes may be needed to describe the condition fully. Whether S22.49XK is sequenced first depends on the reason for the encounter.
How long has S22.49XK existed?
S22.49XK has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.