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S22.042A vs S22.042K

S22.042A (Unstable burst fracture of fourth thoracic vertebra, initial encounter for closed fracture) compared with S22.042K (Unstable burst fracture of fourth thoracic vertebra, subsequent encounter for fracture with nonunion), from the official CMS tabular data. S22.042A and S22.042K code the same injury at a different phase of treatment.

Relationship

Review

Encounter relationship

S22.042A
Initial encounter
Unstable burst fracture of fourth thoracic vertebra, initial encounter for closed fracture
↔
S22.042K
Subsequent encounter
Unstable burst fracture of fourth thoracic vertebra, subsequent encounter for fracture with nonunion

Same underlying diagnosis, different encounter phase.

The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.

Source: ICD-10-CM Official Guidelines, Section I.C.19.a

Can these codes be reported together?

Same injury, other encounter phase. S22.042A and S22.042K code the same injury at a different phase of treatment, set by the 7th character.

The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.

Side by side

S22.042AUnstable burst fracture of fourth thoracic vertebra, initial encounter for closed fractureS22.042KUnstable burst fracture of fourth thoracic vertebra, subsequent encounter for fracture with nonunion
Billing statusBillableBillable
ClassificationS00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
DefinitionUnstable burst fracture of fourth thoracic vertebra, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S22.042A).Unstable burst fracture of fourth thoracic vertebra, subsequent encounter for fracture with nonunion is a billable ICD-10-CM diagnosis code (S22.042K).
7th characterThe appropriate 7th character is to be added to each code from category S22The appropriate 7th character is to be added to each code from category S22
Includes
fracture of thoracic neural arch
fracture of thoracic spinous process
fracture of thoracic transverse process
fracture of thoracic vertebra
fracture of thoracic neural arch
fracture of thoracic spinous process
fracture of thoracic transverse process
fracture of thoracic vertebra
Code first
, if applicable, spinal cord injury (S24.0-, S24.1-)
, if applicable, spinal cord injury (S24.0-, S24.1-)
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Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources