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ICD-10/S22.42XA

S22.42XA ICD-10-CM Code: Multiple fractures of ribs, left side, initial encounter for closed fracture

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 183 — MAJOR CHEST TRAUMA WITH MCC (MDC 04)
  • MS-DRG 184 — MAJOR CHEST TRAUMA WITH CC (MDC 04)
  • MS-DRG 185 — MAJOR CHEST TRAUMA WITHOUT CC/MCC (MDC 04)
  • MS-DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)
  • MS-DRG 964 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC (MDC 24)
  • MS-DRG 965 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC (MDC 24)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Official Registry Overview & Definition

Multiple fractures of ribs, left side, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S22.42A).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S22.42XA in the official ICD-10-CM tabular list.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • fracture of thoracic neural arch
  • fracture of thoracic spinous process
  • fracture of thoracic transverse process
  • fracture of thoracic vertebra
  • fracture of thoracic vertebral arch
  • injuries of breast
  • injuries of chest (wall)
  • injuries of interscapular area

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code First

Underlying conditions that must be sequenced before this code.

  • Code first, if applicable, spinal cord injury (S24.0-, S24.1-)

Code Also

Additional codes that may be required to fully describe the encounter.

  • Code also, if applicable, any associated condition such as:
  • injury of intrathoracic organ (S27.-)
  • traumatic hemopneumothorax (S27.2)
  • traumatic hemothorax (S27.1-)
  • traumatic pneumothorax (S27.0)

Change history

  • FY2027 — 2026-10-01
    Code First note added
    , if applicable, spinal cord injury (S24.0-, S24.1-)
    FY2027 changes
  • FY2027 — 2026-10-01
    Code Also note removed
    spinal cord injury (S24.0-, S24.1-)
    FY2027 changes

Verify Before Coding

  • Billable — reportable as written.
  • CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Contextual Map

Every relationship of S22.42XA in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88) [Hierarchy]
  • S20-S29 — Injuries to the thorax [Hierarchy]

Referenced by Excludes1 notes

  • M48.5 — Collapsed vertebra, not elsewhere classified [Excludes1](via S22.-): “traumatic fracture of vertebra (S12.-, S22.-, S32.-)”
  • M84.3 — Stress fracture [Excludes1](via S22.-): “traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)”
  • M84.4 — Pathological fracture, not elsewhere classified [Excludes1](via S22.-): “traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)”

Referenced by Code Also instructions

  • S21 — Open wound of thorax [Code Also](via S22.4.-): “rib fracture (S22.3-, S22.4-)”

Clinical classification (CCSR)

  • INJ003 — Fracture of torso, initial encounter [CCSR]

Potential MS-DRG

  • CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”
  • DRG 183 — MAJOR CHEST TRAUMA WITH MCC [MS-DRG]: “MAJOR CHEST TRAUMA WITH MCC (MDC 04)”
  • DRG 184 — MAJOR CHEST TRAUMA WITH CC [MS-DRG]: “MAJOR CHEST TRAUMA WITH CC (MDC 04)”
  • DRG 185 — MAJOR CHEST TRAUMA WITHOUT CC/MCC [MS-DRG]: “MAJOR CHEST TRAUMA WITHOUT CC/MCC (MDC 04)”
  • DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)”
  • DRG 964 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC (MDC 24)”
  • DRG 965 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC (MDC 24)”

Nearest codes (40)

  • S22 — Fracture of rib(s), sternum and thoracic spine [Sibling]
  • S22.32XD — Fracture of one rib, left side, subsequent encounter for fracture with routine healing [Sibling]
  • S22.32XG — Fracture of one rib, left side, subsequent encounter for fracture with delayed healing [Sibling]
  • S22.32XK — Fracture of one rib, left side, subsequent encounter for fracture with nonunion [Sibling]
  • S22.32XS — Fracture of one rib, left side, sequela [Sibling]
  • S22.39 — Fracture of one rib, unspecified side [Sibling]
  • S22.39XA — Fracture of one rib, unspecified side, initial encounter for closed fracture [Sibling]
  • S22.39XB — Fracture of one rib, unspecified side, initial encounter for open fracture [Sibling]
  • and 32 more

Change history (2)

  • FY2027 — Code First note added [Change history]
  • and 1 more

Referenced by Other Codes

Clinical classification (AHRQ CCSR):INJ003 — Fracture of torso, initial encounter (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Potential MS-DRG Relationships (FY2026)

CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 40 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 6 MS-DRGs: DRG 183 (MDC 04), DRG 184 (MDC 04), DRG 185 (MDC 04), DRG 963 (MDC 24), DRG 964 (MDC 24), DRG 965 (MDC 24).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Official ICD-10-CM tabular notes on other codes that name S22.42XA or its code family.

3 Excludes1 notes: M48.5 (via S22.-), M84.3 (via S22.-), M84.4 (via S22.-).

1 Code Also instructions: S21 (via S22.4.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Does S22.42XA require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category S22.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to S22.42XA in its code family, with their registry titles.

  • S22.41XD — Multiple fractures of ribs, right side, subsequent encounter for fracture with routine healing
  • S22.41XG — Multiple fractures of ribs, right side, subsequent encounter for fracture with delayed healing
  • S22.41XK — Multiple fractures of ribs, right side, subsequent encounter for fracture with nonunion
  • S22.41XS — Multiple fractures of ribs, right side, sequela
  • S22.42 — Multiple fractures of ribs, left side
  • S22.42XB — Multiple fractures of ribs, left side, initial encounter for open fracture
  • S22.42XD — Multiple fractures of ribs, left side, subsequent encounter for fracture with routine healing
  • S22.42XG — Multiple fractures of ribs, left side, subsequent encounter for fracture with delayed healing
  • S22.42XK — Multiple fractures of ribs, left side, subsequent encounter for fracture with nonunion
  • S22.42XS — Multiple fractures of ribs, left side, sequela

View all codes in the S22 family