Version 2024

2024 ICD-10-CM Diagnosis Code S20.304A

Unspecified superficial injuries of middle front wall of thorax, initial encounter

ICD-10-CM Code:: S20.304A
ICD-10 Code for:: Unsp superfic injuries of middle front wall of thorax, init
Is Billable?: Yes - Valid for Submission
Chronic Condition Indicator: ^[1]: Not chronic
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Code Information
Clinical Classification
Coding Guidelines
Tabular List of Diseases and Injuries
Diagnostic Related Groups Mapping
Replacement Code
Patient Education
Other Codes Used Similar Conditions
Code History

Code Classification

Injury, poisoning and certain other consequences of external causes
(S00–T88)
- Injuries to the thorax
  (S20-S29)
  - Superficial injury of thorax
    (S20)

S20.304A is a billable diagnosis code used to specify a medical diagnosis of unspecified superficial injuries of middle front wall of thorax, initial encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

S20.304A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like unspecified superficial injuries of middle front wall of thorax. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.

Unspecified diagnosis codes like S20.304A are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Clinical Classification

Clinical Category is Superficial injury; contusion, initial encounter
CCSR Category Code: INJ017
Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Coding Guidelines

The appropriate 7th character is to be added to each code from block Superficial injury of thorax (S20). Use the following options for the aplicable episode of care:

A - initial encounter
D - subsequent encounter
S - sequela

S20.304A is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
604	TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC	09	1.5062
605	TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC	09	0.9088

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Replacement Code

S20304A replaces the following previously assigned ICD-10-CM code(s):

S20.301A - Unsp superficial injuries of r frnt wl of thorax, init
S20.302A - Unsp superficial injuries of left front wall of thorax, init
S20.309A - Unsp superficial injuries of unsp front wall of thorax, init

Other ICD-10-CM Codes Commonly Used for Similar Conditions

Filter related codes list:

S20 Superficial injury of thorax.
S20.0 Contusion of breast.
S20.00 Contusion of breast, unspecified breast.
S20.00XA Contusion of breast, unspecified breast, initial encounter.
S20.00XD Contusion of breast, unspecified breast, subsequent encounter.
S20.00XS Contusion of breast, unspecified breast, sequela.
S20.01 Contusion of right breast.
S20.01XA Contusion of right breast, initial encounter.
S20.01XD Contusion of right breast, subsequent encounter.
S20.01XS Contusion of right breast, sequela.
S20.02 Contusion of left breast.
S20.02XA Contusion of left breast, initial encounter.
S20.02XD Contusion of left breast, subsequent encounter.
S20.02XS Contusion of left breast, sequela.
S20.1 Other and unspecified superficial injuries of breast.
S20.10 Unspecified superficial injuries of breast.
S20.101 Unspecified superficial injuries of breast, right breast.
S20.101A Unspecified superficial injuries of breast, right breast, initial encounter.
S20.101D Unspecified superficial injuries of breast, right breast, subsequent encounter.
S20.101S Unspecified superficial injuries of breast, right breast, sequela.
S20.102 Unspecified superficial injuries of breast, left breast.
S20.102A Unspecified superficial injuries of breast, left breast, initial encounter.
S20.102D Unspecified superficial injuries of breast, left breast, subsequent encounter.
S20.102S Unspecified superficial injuries of breast, left breast, sequela.
S20.109 Unspecified superficial injuries of breast, unspecified breast.
S20.109A Unspecified superficial injuries of breast, unspecified breast, initial encounter.
S20.109D Unspecified superficial injuries of breast, unspecified breast, subsequent encounter.
S20.109S Unspecified superficial injuries of breast, unspecified breast, sequela.
S20.11 Abrasion of breast.
S20.111 Abrasion of breast, right breast.
S20.111A Abrasion of breast, right breast, initial encounter.
S20.111D Abrasion of breast, right breast, subsequent encounter.
S20.111S Abrasion of breast, right breast, sequela.
S20.112 Abrasion of breast, left breast.
S20.112A Abrasion of breast, left breast, initial encounter.
S20.112D Abrasion of breast, left breast, subsequent encounter.
S20.112S Abrasion of breast, left breast, sequela.
S20.119 Abrasion of breast, unspecified breast.
S20.119A Abrasion of breast, unspecified breast, initial encounter.
S20.119D Abrasion of breast, unspecified breast, subsequent encounter.
S20.119S Abrasion of breast, unspecified breast, sequela.
S20.12 Blister (nonthermal) of breast.
S20.121 Blister (nonthermal) of breast, right breast.
S20.121A Blister (nonthermal) of breast, right breast, initial encounter.
S20.121D Blister (nonthermal) of breast, right breast, subsequent encounter.
S20.121S Blister (nonthermal) of breast, right breast, sequela.
S20.122 Blister (nonthermal) of breast, left breast.
S20.122A Blister (nonthermal) of breast, left breast, initial encounter.
S20.122D Blister (nonthermal) of breast, left breast, subsequent encounter.
S20.122S Blister (nonthermal) of breast, left breast, sequela.
S20.129 Blister (nonthermal) of breast, unspecified breast.

Code History

FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
FY 2021 - Code Added, effective from 10/1/2020 through 9/30/2021

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.