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S22.20XA
ICD-10-CM
Fracture of Sternum

Learn about sternal fracture diagnosis, clinical documentation, and medical coding. Find information on fracture of sternum, broken sternum, and sternal fracture treatment. This resource offers guidance on healthcare coding for sternum fractures and best practices for clinical documentation of a fractured sternum. Explore details on sternal fracture ICD-10 codes and other relevant medical coding terminology.

Also known as

Sternal Fracture
Broken Sternum

Diagnosis Snapshot

Key Facts
  • Definition : A break in the breastbone (sternum), often caused by trauma.
  • Clinical Signs : Chest pain, tenderness to touch, swelling, bruising, difficulty breathing.
  • Common Settings : Blunt trauma (e.g., car accidents, falls, sports injuries), CPR.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC S22.20XA Coding
S22.2-

Fracture of sternum

Fractures involving the sternum bone.

S22-

Fracture of ribs and sternum

Fractures involving the ribs and/or sternum.

T02.1-

Fracture of multiple ribs

Fractures involving multiple ribs, may include sternal fracture if documented.

S20-S29

Injuries to the thorax

Encompasses various injuries to the chest, including rib and sternal fractures.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the sternal fracture displaced?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Break in the breastbone (sternum).
Bruised or injured breastbone, no fracture.
Separation of the joints between ribs and sternum.

Documentation Best Practices

Documentation Checklist
  • Document mechanism of injury (e.g., blunt trauma, compression).
  • Specify location of fracture (e.g., manubrium, body, xiphoid process).
  • Describe displacement/alignment of fracture fragments.
  • Note associated injuries (e.g., rib fractures, lung contusions).
  • Record pain level and functional limitations.

Coding and Audit Risks

Common Risks
  • Specificity of Fracture

    Coding requires specifying the precise location and type of sternal fracture (e.g., displaced, non-displaced, open, closed) for accurate reimbursement.

  • Associated Injuries

    Sternum fractures often occur with other chest injuries. Incomplete documentation of these comorbidities can lead to undercoding and lost revenue.

  • Trauma Documentation

    Insufficient documentation of the mechanism of injury (e.g., blunt trauma, compression) may hinder accurate coding and affect injury severity scores.

Mitigation Tips

Best Practices
  • ICD-10 S22.-, S22.2-: Accurate sternal fracture documentation.
  • Document fracture type, location, displacement for proper coding.
  • Query physician for laterality, mechanism of injury, associated injuries.
  • CDI: Ensure complete documentation for optimal reimbursement.
  • HCC coding: Capture all comorbidities for accurate risk adjustment.

Clinical Decision Support

Checklist
  • Verify mechanism of injury: high-impact trauma to chest (ICD-10 S22.XXX)
  • Palpate sternum for tenderness, crepitus, deformity (SNOMED CT 263353004)
  • Order chest imaging: CT scan preferred over X-ray for diagnosis (CPT 71250, 71260)
  • Assess for associated injuries: rib fractures, cardiac contusion (ICD-10 S22.4XX, S26.0)
  • Document pain assessment, vital signs, respiratory status (LOINC 72514-3, 8480-6)

Reimbursement and Quality Metrics

Impact Summary
  • Sternum fracture coding accuracy impacts reimbursement for ICD-10-CM codes S22.2-S22.9, ensuring appropriate hospital payment.
  • Accurate sternal fracture diagnosis coding improves quality metrics reporting for trauma care and patient safety indicators.
  • Proper coding of sternum fractures (S22.-) affects hospital value-based purchasing and public performance reporting.
  • Timely and specific sternal fracture documentation optimizes reimbursement and reduces claim denials for orthopedic procedures.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Frequently Asked Questions

Common Questions and Answers

Q: What are the most effective strategies for managing pain associated with a sternal fracture in elderly patients considering their potential comorbidities?

A: Managing pain from a sternal fracture in elderly patients with comorbidities requires a multifaceted approach. Non-opioid analgesics like NSAIDs or acetaminophen are often the first line, but their use must be carefully weighed against potential renal or gastrointestinal complications. Consider implementing regional anesthesia techniques like paravertebral blocks or epidural infusions for improved pain control while minimizing systemic opioid use. For patients with severe pain or multiple comorbidities, a consult with a pain specialist might be beneficial to explore alternative pain management strategies, including opioid medications with close monitoring. Explore how our integrated pain management program addresses complex cases involving sternal fractures in geriatric patients.

Q: How do I differentiate between a simple sternal fracture and a more serious injury like a flail chest or cardiac contusion in a trauma patient?

A: Differentiating a simple sternal fracture from a flail chest or cardiac contusion requires careful clinical evaluation and diagnostic imaging. Palpation for paradoxical chest wall movement is crucial for identifying a flail chest, while auscultation for muffled heart sounds or arrhythmias could suggest cardiac involvement. An ECG should be performed immediately in all trauma patients with suspected sternal fractures. A CT scan of the chest provides detailed anatomical information, allowing for accurate identification of sternal fracture type, associated rib fractures, and the presence of pneumothorax or hemothorax. Echocardiography can further assess cardiac function and identify a contusion. Learn more about the latest guidelines for evaluating and managing thoracic trauma patients.

Quick Tips

Practical Coding Tips
  • Code sternum fracture with S22
  • ICD-10 S22 for sternum fx
  • Document fracture type/location
  • Query physician for specifics
  • Consider 7th character for S22

Documentation Templates

Patient presents with complaints consistent with a sternal fracture.  Onset of symptoms, including anterior chest pain, sternal tenderness, and pain exacerbated by deep breathing or coughing, began after [mechanism of injury - e.g., motor vehicle accident, fall, direct blow to the chest].  Physical examination reveals point tenderness over the sternum, possible crepitus, and ecchymosis.  Pulmonary auscultation reveals [lung sounds - e.g., clear breath sounds bilaterally, diminished breath sounds on the right].  Cardiovascular examination is unremarkable.  Differential diagnosis includes costochondritis, rib fracture, cardiac contusion, and pneumothorax.  Initial assessment suggests a likely diagnosis of a sternal fracture.  Ordered chest x-ray, PA and lateral views, to evaluate for sternal fracture and associated injuries.  ECG performed to rule out cardiac involvement.  Pain management initiated with [medication and dosage].  Patient advised on activity restrictions, including avoiding strenuous activity and lifting.  Follow-up scheduled in [timeframe] for repeat clinical evaluation and review of imaging results.  ICD-10 code S22.___ will be assigned based on the specific location and type of sternal fracture identified on imaging.  Treatment plan will be further refined based on imaging findings and clinical progression.  Patient education provided on sternal fracture healing time, potential complications, and signs and symptoms to monitor.  Referral to [specialist - e.g., cardiothoracic surgery, orthopedic surgery] will be considered if indicated by imaging or clinical course.