T22.30XA — Burn of third degree of shoulder and upper limb, except wrist and hand, unspecified site, initial encounter
Is T22.30XA billable?
Yes, but T22.30XA will trip a Medicare edit. T22.30XA is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists T22.30XA 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
- T22.311ABurn of third degree of right forearm, initial encounter
- T22.321ABurn of third degree of right elbow, initial encounter
- T22.331ABurn of third degree of right upper arm, initial encounter
- T22.341ABurn of third degree of right axilla, initial encounter
- T22.351ABurn of third degree of right shoulder, initial encounter
- T22.361ABurn of third degree of right scapular region, initial encounter
- T22.391ABurn of third degree of multiple sites of right shoulder and upper limb, except wrist and hand, initial encounter
T22.30XA at a glance
| Code | T22.30XA |
|---|---|
| Description | Burn of third degree of shoulder and upper limb, except wrist and hand, unspecified site, initial encounter |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter |
What does the 7th character "A" mean in T22.30XA?
In T22.30XA, the 7th character A means initial encounter. The 7th character is required for T22.30XA to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to T22.30XA?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name T22.30XA 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 T22.30XA group to?
T22.30XA sits in MDC 22 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 927Extensive Burns or Full Thickness Burns with MV >96 Hours with Skin Graftsurgical
- 933Extensive Burns or Full Thickness Burns with MV >96 Hours without Skin Graftmedical
As a secondary diagnosis, T22.30XA is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG. It also carries Hospital-Acquired Condition category 05.
How is T22.30XA listed in the Alphabetic Index?
The Alphabetic Index lists these routes under T22.30, the nearest indexed parent of T22.30XA. Use them to find the family, then select the specific code.
- Burn › upper limb › third degree (electricity) (flame) (hot gas, liquid or hot object) (radiation) (steam) (thermal)
Use additional code — inherited from Chapter 19
Report an additional code alongside T22.30XA to fully describe the condition. T22.30XA is sequenced first.
- code to identify any retained foreign body, if applicable (Z18.-)
Use additional code — inherited from T20-T25
Report an additional code alongside T22.30XA to fully describe the condition. T22.30XA is sequenced first.
Use additional code — inherited from T22.3
Report an additional code alongside T22.30XA to fully describe the condition. T22.30XA is sequenced first.
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T22.30XA, but a patient may have both at the same time. When documentation supports it, T22.30XA and the excluded code may both be reported.
Excludes2 — not included here — inherited from T22
The conditions below are not part of T22.30XA, but a patient may have both at the same time. When documentation supports it, T22.30XA and the excluded code may both be reported.
How long has T22.30XA existed?
T22.30XA 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.