S28.0 ICD-10-CM Code: Crushed chest

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for S28.0 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on S28.0 itself; “inherited from” names the category or block whose note applies here.

7th Character Guide

"The appropriate 7th character is to be added to each code from category S28"

• A — initial encounter
• D — subsequent encounter
• S — sequela

How the encounter character is assigned. “Initial encounter” means the patient is receiving active treatment for the condition — it is not limited to the first visit, and a different or new provider giving active treatment still assigns it. “Subsequent encounter” covers care during the healing or recovery phase after active treatment. “Sequela” is for complications or conditions that arise as a direct result of the original condition.

ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.19.a (paraphrased by MedCoder).

Variant codes in this family

S28.0XXA, S28.0XXD, S28.0XXS

Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.

Coder workflow for S28.0

MedCoder structured workflow — derived from this code’s own official record

Before you code S28.0

1. S28.0 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

   ReviewS28.0XXA, S28.0XXD, S28.0XXS

   See the relationships section · Guide: How to choose an ICD-10-CM code →

2. A 7th character is required in this family. Confirm the documented encounter: initial (active treatment), subsequent (healing or recovery phase), or sequela. S28.0 is not valid without one. “Initial” means active treatment, not the first visit (Guidelines I.C.19.a).

   See the 7th Character Guide · Guide: 7th characters: initial, subsequent, sequela →

3. Confirm the injury type, the anatomical site at the most specific level documented, laterality where the family codes it, and the encounter for the 7th character. Each injury is coded separately unless the classification provides a combination code, and a superficial injury is not coded when a more severe injury of the same site is documented. Injury chapter guidelines (Guidelines I.C.19.b, I.C.19.b.1).

   Guide: 7th characters: initial, subsequent, sequela →

4. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with S28.0. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

   See the official tabular notes

Choose the right path

1. Does the documentation support one of the more specific codes beneath S28.0?
   Yes → Select that code and continue the checks below on its own page.
   No → S28.0 cannot be reported as written; query for the specificity its subcategory needs.

   ReviewS28.0XXA, S28.0XXD, S28.0XXS

2. Does the documentation support a condition named in S28.0’s Excludes1 note?
   Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
   No → Continue.

   ReviewS22.5

3. Is the encounter phase documented — active treatment, healing or recovery, or a sequela?
   Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
   No → The code is invalid without its 7th character — query for the missing element.

Consider S28.0. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Anatomical site

At the most specific level the record states; a site the classification separates cannot be assumed from a procedure or a measurement.

Encounter type

Active treatment, healing or recovery phase, or sequela — the basis of the 7th character (Guidelines I.C.19.a).

The conditions the Use Additional Code note names

Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

External cause, place and activity

For the external cause codes reported with the injury or poisoning, where documented (Guidelines I.C.20.a).

Official instructions as workflow

• Excludes1 — check before selecting S28.0(1 note)

  Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with S28.0: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

  CompareS22.5

  See the official tabular notes · Guidelines I.A.12.a

• Excludes2 — not part of S28.0(11 notes)

  Coding workflow: The conditions named in this note are not included in S28.0. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareT17.5, T18.1, T17.8, T17.4, T63.4

  See the official tabular notes · Guidelines I.A.12.b

• Use Additional Code — after identifying S28.0(1 note)

  Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with S28.0 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

  See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Indexed Clinical Terms (3)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Asphyxia, asphyxiation (by), crushing
• Asphyxia, asphyxiation (by), traumatic, due to, crushed chest
• Crush, crushed, crushing, chest

Don’t confuse S28.0 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of S28.0 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• S22.5— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of flail chest moves the case to S22.5; the two are not reported together unless documented as unrelated.

  Full comparison: S28.0 vs S22.5 →

• S28.0XXA— Encounter relationship (Review)

  Same underlying diagnosis, different encounter phase.

  The same diagnosis at a different phase of care; one encounter takes one 7th character.

  What moves you there: Documentation of a initial encounter moves the case to S28.0XXA.

  Full comparison: S28.0 vs S28.0XXA →

• S28.0XXD— Encounter relationship (Review)

  Same underlying diagnosis, different encounter phase.

  The same diagnosis at a different phase of care; one encounter takes one 7th character.

  What moves you there: Documentation of a subsequent encounter moves the case to S28.0XXD.

  Full comparison: S28.0 vs S28.0XXD →

• T20— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of burns and corrosions adds T20; it is not part of this code and both may be reported when both are documented.

  Full comparison: S28.0 vs T20 →

• T32— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of burns and corrosions adds T32; it is not part of this code and both may be reported when both are documented.

  Full comparison: S28.0 vs T32 →

• T17.5— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of effects of foreign body in bronchus adds T17.5; it is not part of this code and both may be reported when both are documented.

  Full comparison: S28.0 vs T17.5 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

1. A 7th character applies in this family. Confirm the documented encounter matches the character assigned. See the official 7th-character definitions and this code’s variants
2. 1 Use Additional Code instruction — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
3. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
4. 11 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

• Not billable as written — a more specific code is required: S28.0XXA, S28.0XXD, S28.0XXS.
• Requires a 7th character. "The appropriate 7th character is to be added to each code from category S28" Options: S28.0XXA, S28.0XXD, S28.0XXS

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

Related Codes

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Crush, crushed, crushing”, “Asphyxia, asphyxiation”; these codes share that main term but sit in a different category of the Tabular List.

P84 — Other problems with newborn (birth), R09.01 — Asphyxia, R23.1 — Pallor (reticularis), S07.0 — Crushing injury of face (ear), S07.1 — Crushing injury of skull (skull), S07.8 — Crushing injury of other parts of head (scalp), S07.9 — Crushing injury of head, part unspecified (head), S17.0 — Crushing injury of larynx and trachea (larynx), S17.8 — Crushing injury of other specified parts of neck (throat), S17.9 — Crushing injury of neck, part unspecified (neck), S38.001 — Crushing injury of unspecified external genital organs, male (genitalia, external, male), S38.002 — Crushing injury of unspecified external genital organs, female (genitalia, external, female), S38.01 — Crushing injury of penis (penis), S38.02 — Crushing injury of scrotum and testis (testis), S38.03 — Crushing injury of vulva (vulva), S38.1 — Crushing injury of abdomen, lower back, and pelvis (pelvis), S57.0 — Crushing injury of elbow (elbow), S57.8 — Crushing injury of forearm (forearm), S67.0 — Crushing injury of thumb (thumb), S67.1 — Crushing injury of other and unspecified finger(s) (finger), +59 more

Contextual Map

Every relationship of S28.0 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.

Run S28.0 with this related code in Claim Check

Hierarchy

• S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S20-S29 — Injuries to the thorax[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Excludes1

• S22.5 — Flail chest[Excludes1]: “flail chest (S22.5)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Index entries

• Asphyxia, asphyxiation (by), crushing[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Asphyxia, asphyxiation (by), traumatic, due to, crushed chest[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Crush, crushed, crushing, chest[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (35)

• S28 — Crushing injury of thorax, and traumatic amputation of part of thorax[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S28.0XXA — Crushed chest, initial encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S28.0XXD — Crushed chest, subsequent encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S28.0XXS — Crushed chest, sequela[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S28.1 — Traumatic amputation (partial) of part of thorax, except breast[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S28.1XXA — Traumatic amputation (partial) of part of thorax, except breast, initial encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S28.1XXD — Traumatic amputation (partial) of part of thorax, except breast, subsequent encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S28.1XXS — Traumatic amputation (partial) of part of thorax, except breast, sequela[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 27 more

Change history

• FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Common coding questions

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to S28.0 in its code family, with their registry titles.

• S28 — Crushing injury of thorax, and traumatic amputation of part of thorax
• S28.0XXA — Crushed chest, initial encounter
• S28.0XXD — Crushed chest, subsequent encounter
• S28.0XXS — Crushed chest, sequela
• S28.1 — Traumatic amputation (partial) of part of thorax, except breast
• S28.1XXA — Traumatic amputation (partial) of part of thorax, except breast, initial encounter
• S28.1XXD — Traumatic amputation (partial) of part of thorax, except breast, subsequent encounter
• S28.1XXS — Traumatic amputation (partial) of part of thorax, except breast, sequela
• S28.2 — Traumatic amputation of breast
• S28.21 — Complete traumatic amputation of breast

View all codes in the S28 family