S22.20XB vs S42.1
S22.20XB (Unspecified fracture of sternum, initial encounter for open fracture) compared with S42.1 (Fracture of scapula), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. S22.20XB carries an Excludes2 note covering S42.1: “fracture of scapula (S42.1-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| S22.20XBUnspecified fracture of sternum, initial encounter for open fracture | S42.1Fracture of scapula | |
|---|---|---|
| Billing status | Billable | Non-billable header Report instead: S42.101A, S42.101B, S42.101D, S42.101G, S42.101K |
| Classification | S00-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) |
| Definition | Unspecified fracture of sternum, initial encounter for open fracture is a billable ICD-10-CM diagnosis code (S22.20B). | Fracture of scapula is a non-billable ICD-10-CM category code (S42.1). |
| 7th character | The appropriate 7th character is to be added to each code from category S22 | The appropriate 7th character is to be added to all codes from category S42 |
| Includes | fracture of thoracic neural arch fracture of thoracic spinous process fracture of thoracic transverse process fracture of thoracic vertebra | injuries of axilla injuries of scapular region |
| Code first | , if applicable, spinal cord injury (S24.0-, S24.1-) | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources