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ICD-10/S22.49XS

S22.49XS ICD-10-CM Code: Multiple fractures of ribs, unspecified side, sequela

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 551 — MEDICAL BACK PROBLEMS WITH MCC (MDC 08)
  • MS-DRG 552 — MEDICAL BACK PROBLEMS WITHOUT MCC (MDC 08)

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, unspecified side, sequela is a billable ICD-10-CM diagnosis code (S22.49S).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S22.49XS 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.

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 S22.49XS 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.-)” · check together
  • M84.3 — Stress fracture [Excludes1](via S22.-): “traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)” · check together
  • M84.4 — Pathological fracture, not elsewhere classified [Excludes1](via S22.-): “traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)” · check together

Referenced by Code Also instructions

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

Clinical classification (CCSR)

  • INJ073 — Injury, sequela [CCSR]

Potential MS-DRG

  • DRG 551 — MEDICAL BACK PROBLEMS WITH MCC [MS-DRG]: “MEDICAL BACK PROBLEMS WITH MCC (MDC 08)”
  • DRG 552 — MEDICAL BACK PROBLEMS WITHOUT MCC [MS-DRG]: “MEDICAL BACK PROBLEMS WITHOUT MCC (MDC 08)”

MDC crossing · procedures (18508)

  • MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue [MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 005T0ZZ — Destruction of Spinal Meninges, Open Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T3ZZ — Destruction of Spinal Meninges, Percutaneous Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T4ZZ — Destruction of Spinal Meninges, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Endoscopic Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0Z3 — Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0ZZ — Destruction of Cervical Spinal Cord, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • and 18503 more

Nearest codes (40)

  • S22 — Fracture of rib(s), sternum and thoracic spine [Sibling]
  • S22.41XA — Multiple fractures of ribs, right side, initial encounter for closed fracture [Sibling]
  • S22.41XB — Multiple fractures of ribs, right side, initial encounter for open fracture [Sibling]
  • S22.41XD — Multiple fractures of ribs, right side, subsequent encounter for fracture with routine healing [Sibling]
  • S22.41XG — Multiple fractures of ribs, right side, subsequent encounter for fracture with delayed healing [Sibling]
  • S22.41XK — Multiple fractures of ribs, right side, subsequent encounter for fracture with nonunion [Sibling]
  • S22.41XS — Multiple fractures of ribs, right side, sequela [Sibling]
  • S22.42 — Multiple fractures of ribs, left side [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):INJ073 — Injury, sequela (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)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 2 MS-DRGs: DRG 551 (MDC 08), DRG 552 (MDC 08).

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 S22.49XS 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 S22.49XS 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 S22.49XS in its code family, with their registry titles.

  • S22.49XA — Multiple fractures of ribs, unspecified side, initial encounter for closed fracture
  • S22.49XB — Multiple fractures of ribs, unspecified side, initial encounter for open fracture
  • S22.49XD — Multiple fractures of ribs, unspecified side, subsequent encounter for fracture with routine healing
  • S22.49XG — Multiple fractures of ribs, unspecified side, subsequent encounter for fracture with delayed healing
  • S22.49XK — Multiple fractures of ribs, unspecified side, subsequent encounter for fracture with nonunion
  • S22.5 — Flail chest
  • S22.5XXA — Flail chest, initial encounter for closed fracture
  • S22.5XXB — Flail chest, initial encounter for open fracture
  • S22.5XXD — Flail chest, subsequent encounter for fracture with routine healing
  • S22.5XXG — Flail chest, subsequent encounter for fracture with delayed healing

View all codes in the S22 family