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S22.5 vs S28.0

S22.5 (Flail chest) compared with S28.0 (Crushed 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. S28.0 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

S22.5Flail chestS28.0Crushed chest
Billing statusNon-billable header

Report instead: S22.5XXA, S22.5XXB, S22.5XXD, S22.5XXG, S22.5XXK

Non-billable header

Report instead: S28.0XXA, S28.0XXD, S28.0XXS

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)
DefinitionFlail chest is a non-billable ICD-10-CM category code (S22.5).Crushed chest is a non-billable ICD-10-CM category code (S28.0).
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 S28
Includes
fracture of thoracic neural arch
fracture of thoracic spinous process
fracture of thoracic transverse process
fracture of thoracic vertebra
injuries of breast
injuries of chest (wall)
injuries of interscapular area
Use additional code
code for all associated injuries
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