2027 ICD-10-CM Diagnosis Code S22.5XXDFlail chest, subsequent encounter for fracture with routine healing

ICD-10-CM Codes›S00–T88›S20-S29›s

ICD-10-CM S22.5XXD
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

S22.5XXD is a billable ICD-10-CM diagnosis code for flail chest, subsequent encounter for fracture with routine healing. The 7th character D means subsequent encounter for fracture with routine healing, used during routine care in the healing or recovery phase. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 559 through 561. The code is exempt from POA reporting. Coders also document this condition as closed flail chest. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Fracture of torso, subsequent encounter.

Code Identity

ICD-10-CM Code
S22.5XXD
Billable Status
Yes — Valid for Submission
Code Describes
Flail chest, subsequent encounter for fracture with routine healing
Short Description
Flail chest, subs encntr for fracture with routine healing
Parent Code
S22.5
Flail chest

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionS20-S29Injuries to the thorax
CategorysFracture of rib, sternum and thoracic spine (S22)
This CodeS22.5XXDFlail chest, subsequent encounter for fracture with routine healing

Present on Admission (POA)Billing

S22.5XXD is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Injuries to the thorax (S20-S29).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Closed flail chest
  • Flail chest
  • Flail sternum
  • Open flail chest

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 2027, published by CMS and the National Center for Health Statistics.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to S22.5XXD: its own notes plus those printed at S22, block S20-S29, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From S22 Fracture of rib(s), sternum and thoracic spine applies to 354 codes
  • fracture of thoracic neural arch
  • fracture of thoracic spinous process
  • fracture of thoracic transverse process
  • fracture of thoracic vertebra
  • fracture of thoracic vertebral arch
From Block S20-S29 Injuries to the thorax applies to 1,602 codes
  • injuries of breast
  • injuries of chest (wall)
  • injuries of interscapular area

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From S22 Fracture of rib(s), sternum and thoracic spine applies to 354 codes
  • transection of thorax (S28.1)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From S22 Fracture of rib(s), sternum and thoracic spine applies to 354 codes
From Block S20-S29 Injuries to the thorax applies to 1,602 codes
  • 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)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes

Code First

The underlying condition named in the note is sequenced before this code.

From S22 Fracture of rib(s), sternum and thoracic spine applies to 354 codes

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • code to identify any retained foreign body, if applicable (Z18.-)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From S22 Fracture of rib(s), sternum and thoracic spine applies to 354 codes
  • if applicable, any associated condition such as:
  • injury of intrathoracic organ (S27.-)
  • traumatic hemopneumothorax (S27.2)
  • traumatic hemothorax (S27.1-)
  • traumatic pneumothorax (S27.0)

Notes

General instructions on how these codes are used.

From S22 Fracture of rib(s), sternum and thoracic spine applies to 354 codes
  • A fracture not indicated as displaced or nondisplaced should be coded to displaced
  • A fracture not indicated as open or closed should be coded to closed
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
  • The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.

7th Character

Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.

From S22 Fracture of rib(s), sternum and thoracic spine applies to 354 codes
  • The appropriate 7th character is to be added to each code from category S22
Values for category S22 Skull, Spine and Pelvis Fracture Encounter
  • Ainitial encounter for closed fracture
  • Binitial encounter for open fracture
  • Dsubsequent encounter for fracture with routine healing this code
  • Gsubsequent encounter for fracture with delayed healing
  • Ksubsequent encounter for fracture with nonunion
  • Ssequela

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name S22.5XXD, its category, or a range that includes it.

Excludes1 5

These codes carry an Excludes1 note naming S22.5XXD: they are not reported together with it, unless the two conditions are unrelated.

  • M48.5 Collapsed vertebra, not elsewhere classified
    traumatic fracture of vertebra (S12.-, S22.-, S32.-) names S22.-, which includes this code
  • M84.3 Stress fracture
    traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-) names S22.-, which includes this code
  • M84.4 Pathological fracture, not elsewhere classified
    traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-) names S22.-, which includes this code
  • S22.4 Multiple fractures of ribs
    flail chest (S22.5-) names S22.5-, which includes this code
  • S28.0 Crushed chest
    flail chest (S22.5) names S22.5, which includes this code

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ040
Fracture of torso, subsequent encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Flail Chest

    a complication of multiple rib fractures; rib and sternum fractures, or thoracic surgery. a portion of the thoracic wall becomes isolated from the rib cage and exhibits paradoxical respiration.

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 S22.5XXD to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
V54.19 Aftrce traum fx bone NEC
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About S22.5XXDOverview

What is the ICD-10 code for flail chest, subsequent encounter for fracture with routine healing?

The ICD-10-CM code for flail chest, subsequent encounter for fracture with routine healing is S22.5XXD (sometimes written as S225XXD). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is S22.5XXD (Flail chest) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report flail chest, subsequent encounter for fracture with routine healing on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character D in S22.5XXD mean?

The final character D marks a subsequent encounter: use it for routine care while the flail chest is healing, after active treatment has ended. In this category the CMS Tabular List defines D as "subsequent encounter for fracture with routine healing".

What MS-DRG does S22.5XXD group to?

When flail chest, subsequent encounter for fracture with routine healing is the principal diagnosis on an inpatient stay, it groups to MS-DRG 559, 561, 560, with relative weights from 0.8258 to 1.8087 depending on complications. Higher weights mean higher Medicare reimbursement.

Is S22.5XXD 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 flail chest, subsequent encounter for fracture with routine healing on inpatient claims. The code appears in the Injuries to the thorax (S20-S29) range of the CMS exempt list.