2026 ICD-10-CM Diagnosis Code S22.49XDMultiple fractures of ribs, unspecified side, subsequent encounter for fracture with routine healing
S22.49XD is a billable ICD-10-CM diagnosis code for multiple fractures of ribs, unspecified side, subsequent encounter for fracture with routine healing. The 7th character D marks it as a subsequent encounter code, used during routine care in the healing or recovery phase. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 559 through 561. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Fracture of torso, subsequent encounter.
Code Identity
Code Classification
Present on Admission (POA)Billing
S22.49XD is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Closed fracture of eight OR more ribs
- Closed fracture of five ribs
- Closed fracture of four ribs
- Closed fracture of multiple ribs
- Closed fracture of seven ribs
- Closed fracture of six ribs
- Closed fracture of three ribs
- Closed fracture of two ribs
- Closed multiple fractures of lower limb AND ribs
- Closed multiple fractures of upper limb with ribs
- Cough fracture of ribs
- Fracture of eight OR more ribs
- Fracture of five ribs
- Fracture of four ribs
- Fracture of multiple ribs
- Fracture of seven ribs
- Fracture of six ribs
- Fracture of three ribs
- Fracture of two ribs
- Multiple fractures of lower limb AND ribs
- Multiple fractures of lower limb AND sternum
- Multiple fractures of lower limb with ribs AND sternum
- Multiple fractures of upper limb with ribs
- Multiple fractures of upper limb with sternum
- Multiple fractures of upper limb with sternum AND ribs
- Open fracture of eight OR more ribs
- Open fracture of five ribs
- Open fracture of four ribs
- Open fracture of multiple ribs
- Open fracture of seven ribs
- Open fracture of six ribs
- Open fracture of sternum
- Open fracture of three ribs
- Open fracture of two ribs
- Open multiple fractures of lower limb AND sternum
- Open multiple fractures of lower limb with ribs AND sternum
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
Chest Injuries and Disorders
The chest is the part of your body between your neck and your abdomen (belly). The medical term for your chest is thorax.
The full article covers:
- What is the chest?
- What are chest injuries and disorders?
- How are chest injuries and disorders diagnosed?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S22.49XD to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S22.49XDOverview
Is S22.49XD (Multiple fractures of ribs, unspecified side) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report multiple fractures of ribs, unspecified side, subsequent encounter for fracture with routine healing on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character D in S22.49XD mean?
The final character D marks a subsequent encounter: use it for routine care while the multiple fractures of ribs, unspecified side is healing, after active treatment has ended.
What MS-DRG does S22.49XD group to?
When multiple fractures of ribs, unspecified side, subsequent encounter for fracture with routine healing is the principal diagnosis on an inpatient stay, it groups to MS-DRG 559, 560, 561, with relative weights from 0.8039 to 1.8649 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S22.49XD exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for multiple fractures of ribs, unspecified side, subsequent encounter for fracture with routine healing on inpatient claims.
What is the ICD-9 equivalent of S22.49XD?
Under the General Equivalence Mappings, multiple fractures of ribs, unspecified side, subsequent encounter for fracture with routine healing converts to ICD-9-CM V54.19 (aftrce traum fx bone NEC). 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.
