S22.41XS (Multiple fractures of ribs, right side, sequela) compared with S22.5 (Flail chest), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Not coded here — these two are mutually exclusive.
“flail chest (S22.5-)”
An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as unrelated to each other.
Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a
No — do not report together. S22.41XS carries an Excludes1 note covering S22.5: “flail chest (S22.5-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
| S22.41XSMultiple fractures of ribs, right side, sequela | S22.5Flail chest | |
|---|---|---|
| Billing status | Billable | Non-billable header |
| 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 | Multiple fractures of ribs, right side, sequela is a billable ICD-10-CM diagnosis code (S22.41S). | Flail chest is a non-billable ICD-10-CM category code (S22.5). |
| 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 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-) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources