S22.43XB vs S22.5
S22.43XB (Multiple fractures of ribs, bilateral, initial encounter for open fracture) 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.
Can these codes be reported together?
No — do not report together. S22.43XB 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).
Side by side
| S22.43XBMultiple fractures of ribs, bilateral, initial encounter for open fracture | S22.5Flail chest | |
|---|---|---|
| Billing status | Billable | Non-billable header Report instead: S22.5XXA, S22.5XXB, S22.5XXD, S22.5XXG, S22.5XXK |
| 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, bilateral, initial encounter for open fracture is a billable ICD-10-CM diagnosis code (S22.43B). | 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