2026 ICD-10-CM Diagnosis Code S22.009AUnspecified fracture of unspecified thoracic vertebra, initial encounter for closed fracture
S22.009A is a billable ICD-10-CM diagnosis code for unspecified fracture of unspecified thoracic vertebra, initial encounter for closed fracture. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 551 through 552, 963 through 965. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Fracture of the spine and back, initial encounter.
Code Identity
Code Classification
Quality Payment Program MeasuresBilling
Medicare quality measures that can apply when S22.009A is part of the patient record.
Communication with the Physician or Other Clinician Managing On-Going Care Post-Fracture for Men and Women Aged 50 Years and Older
High Priority: YES
Measure Type: Process
Submission Methods: Claims, Registry
Description: Percentage of patients aged 50 years and older treated for a fracture with documentation of communication, between the physician treating the fracture and the physician or other clinician managing the patient's on-going care, that a fracture occurred and that the patient was or should be considered for osteoporosis treatment or testing. This measure is submitted by the physician who treats the fracture and who therefore is held accountable for the communication.
Osteoporosis Management in Women Who Had a Fracture
High Priority: NO
Measure Type: Process
Submission Methods: Claims, Registry
Description: The percentage of women 50-85 years of age who suffered a fracture and who had either a bone mineral density (BMD) test or prescription for a drug to treat osteoporosis in the six months after the fracture.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Anterior cord syndrome due to closed fracture of T1-T6 level
- Anterior cord syndrome due to closed fracture of T7-T12 level
- Anterior cord syndrome due to injury at T7-T12 level
- Anterior cord syndrome due to open fracture of T1-T6 level
- Anterior cord syndrome due to open fracture of T7-T12 level
- Central cord syndrome of thoracic spinal cord due to closed fracture at T1-T6 level
- Central cord syndrome of thoracic spinal cord due to closed fracture at T7-T12 level
- Central cord syndrome of thoracic spinal cord due to injury of spinal cord at T7 - T12 level
- Central cord syndrome of thoracic spinal cord due to open fracture at T1-T6 level
- Central cord syndrome of thoracic spinal cord due to open fracture at T7-T12 level
- Central cord syndrome of thoracic spinal cord due to traumatic injury
- Closed fracture of T1-T6 level with incomplete spinal cord lesion
- Closed fracture of T1-T6 level with spinal cord injury
- Closed fracture of T7-T12 level with incomplete spinal cord lesion
- Closed fracture of T7-T12 level with spinal cord injury
- Closed fracture of thoracic region with spinal cord injury
- Closed fracture thoracic vertebra
- Closed fracture thoracic vertebra, posterior arch
- Closed fracture thoracic vertebra, spinous process
- Closed fracture thoracic vertebra, spondylolysis
- Closed fracture thoracic vertebra, transverse process
- Closed fracture thoracic vertebra, tricolumnar
- Closed multiple fractures of thoracic spine
- Closed spinal fracture with anterior thoracic cord lesion, T1-6
- Closed spinal fracture with anterior thoracic cord lesion,T7-12
- Closed spinal fracture with complete thoracic cord lesion, T1-6
- Closed spinal fracture with complete thoracic cord lesion,T7-12
- Closed spinal fracture with posterior thoracic cord lesion, T1-6
- Closed spinal fracture with posterior thoracic cord lesion, T7-12
- Complete spinal cord injury at T1-T6 level
- Complete spinal cord injury at T7-T12 level
- Fracture dislocation of spine
- Fracture dislocation of thoracic spine
- Fracture dislocation of thoracolumbar junction
- Fracture of lamina of thoracic vertebra
- Fracture of pedicle of thoracic vertebra
- Fracture of posterior vertebral body of thoracic vertebra
- Fracture of spinous process of thoracic vertebra
- Fracture of thoracic spine
- Fracture of thoracic spine with cord lesion
- Fracture of transverse process of thoracic vertebra
- Multiple fractures of thoracic spine
- Open fracture of T1-T6 level with spinal cord injury
- Open fracture of T7-T12 level with incomplete spinal cord lesion
- Open fracture of T7-T12 level with spinal cord injury
- Open fracture of thoracic spine with spinal cord injury
- Open fracture thoracic vertebra
- Open fracture thoracic vertebra, posterior arch
- Open fracture thoracic vertebra, spinous process
- Open fracture thoracic vertebra, spondylolysis
- Open fracture thoracic vertebra, transverse process
- Open multiple fracture of thoracic spine
- Open spinal fracture with anterior thoracic cord lesion, T1-6
- Open spinal fracture with complete thoracic cord lesion, T1-6
- Open spinal fracture with complete thoracic cord lesion, T7-12
- Open spinal fracture with posterior thoracic cord lesion, T1-6
- Open spinal fracture with posterior thoracic cord lesion, T7-12
- Posterior cord syndrome due to closed fracture of T1-T6 level
- Posterior cord syndrome due to closed fracture of T7-T12 level
- Posterior cord syndrome due to open fracture of T1-T6 level
- Posterior cord syndrome due to open fracture of T7-T12 level
- Spondylolysis of thoracic vertebra
- Three column fracture of thoracic vertebra
- Traumatic anterior cord syndrome
Coding GuidelinesGuidance
The principles of multiple coding of injuries should be followed in coding fractures. Fractures of specified sites are coded individually by site, to the level of detail furnished by medical record content.
A fracture not indicated as open or closed should be coded to closed. A fracture not indicated whether displaced or not displaced should be coded to displaced.
Initial vs. Subsequent Encounter for Fractures
Traumatic fractures are coded using the appropriate 7th character for initial encounter (A, B, C) while the patient is receiving active treatment for the fracture. The appropriate 7th character for initial encounter should also be assigned for a patient who delayed seeking treatment for the fracture or nonunion.
Fractures are coded using the appropriate 7th character for subsequent care for encounters after the patient has completed active treatment of the fracture and is receiving routine care for the fracture during the healing or recovery phase.
Care for complications of surgical treatment for fracture repairs during the healing or recovery phase should be coded with the appropriate complication codes.
Care of complications of fractures, such as malunion and nonunion, should be reported with the appropriate 7th character for subsequent care with nonunion (K, M, N) or subsequent care with malunion (P, Q, R).
The open fracture designations in the assignment of the 7th character for fractures of the forearm, femur and lower leg, including ankle are based on the Gustilo open fracture classification. When the Gustilo classification type is not specified for an open fracture, the 7th character for open fracture type I or II should be assigned (B, E, H, M, Q).
Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026, published by CMS and the National Center for Health Statistics.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Fractures
A fracture is a break in a bone. Fractures are usually caused by injuries. Since they can sometimes be serious, it's important to get medical care right away if you think you have a fracture.
The full article covers:
- What is a fracture?
- What are the different types of fractures?
- What causes fractures?
- What are the symptoms of a fracture?
- How are fractures diagnosed?
- What are the treatments for fractures?
- Can fractures be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S22.009A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S22.009AOverview
Is S22.009A (Unspecified fracture of unspecified thoracic vertebra) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report unspecified fracture of unspecified thoracic vertebra, initial encounter for closed fracture on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in S22.009A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for unspecified fracture of unspecified thoracic vertebra, such as an emergency visit or first evaluation.
What MS-DRG does S22.009A group to?
When unspecified fracture of unspecified thoracic vertebra, initial encounter for closed fracture is the principal diagnosis on an inpatient stay, it groups to MS-DRG 551, 552, 963, 964, 965, with relative weights from 0.9405 to 2.7338 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of S22.009A?
Under the General Equivalence Mappings, unspecified fracture of unspecified thoracic vertebra, initial encounter for closed fracture converts to ICD-9-CM 805.2 (fx dorsal vertebra-close). The mapping is approximate, so confirm the match fits the documentation.
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.
