S22.041B Stable burst fracture of fourth thoracic vertebra, initial encounter for open fracture

ICD-10-CM S22.041B: Stable burst fracture of fourth thoracic vertebra, initial encounter for open fracture

ICD-10-CM code S22.041B designates a stable burst fracture of the fourth thoracic vertebra during an initial encounter for an open fracture. This diagnosis concept represents a specific type of vertebral injury, and clinical literature indicates that burst fractures can be stable or unstable based on ligamentous integrity. The code is listed as billable and appears in official billing guidance. 3 4 6

Plain-language overview

A burst fracture is a type of spinal injury that can be classified as either stable or unstable depending on the extent of damage to the ligaments and intervertebral discs. This classification exists independently of whether a neurological injury is present. 1

What this code represents

The diagnosis code S22.041B specifically represents a stable burst fracture of the fourth thoracic vertebra. The seventh character B indicates this is an initial encounter for an open fracture. 3 6

The code S22.041B is considered a billable diagnosis code. It can be used for reimbursement and coding purposes because it is specified at the necessary level of detail. 6

Coding details

Within the thoracic vertebra burst fracture coding hierarchy, S22.041B is distinct from S22.042B, which designates an unstable burst fracture of the fourth thoracic vertebra. This distinction allows coders to capture the stability of the injury. 3

Documentation considerations

For this diagnosis code to count as a valid risk adjustment condition, provider documentation must show that the condition was monitored, evaluated, assessed, or treated during the encounter. The documentation must be specific enough to demonstrate the provider addressed the fracture. 6

Coverage and utilization context

Under the CMS-HCC V28 risk adjustment model, S22.041B maps to Vertebral Fractures without Spinal Cord Injury (HCC 401) and carries a community, non-dual, aged base RAF weight of 0.522. 6

What the sources add

The Illinois Department of Public Health source provides the official code description and its placement among other thoracic vertebra fracture codes, while the HCC Buddy source adds operational context by explaining the code's billable status and risk adjustment mapping. 3 6

The CMS billing and coding articles list S22.041B and its associated description within official guidance, whereas the clinical literature from NCBI explains the underlying medical distinction between stable and unstable burst fractures. 1 4 5

Questions to verify

Does the clinical documentation explicitly support that the fourth thoracic vertebra fracture is stable rather than unstable, and does it confirm the open nature of the fracture for the initial encounter? 3 6

Sources

1. Bookshelf — ncbi.nlm.nih.gov; accessed 2026-07-25.
2. Functional and Radiological Outcomes of Short-Segment Fixation With Intermediate Screws for Thoracolumbar Spine Fractures — pmc.ncbi.nlm.nih.gov; accessed 2026-07-25.
3. Head and Spinal Cord ICD-10 Inclusion Codes — dph.illinois.gov; accessed 2026-07-25.
4. Article - Billing and Coding: Bone Mass Measurement (A59040) — cms.gov; accessed 2026-07-25.
5. Article - Billing and Coding: Bone Mass Measurement (A57132) — cms.gov; accessed 2026-07-25.
6. 2026 ICD-10-CM S22.041B: Stable burst fracture | HCC 401 — hccbuddy.com; accessed 2026-07-25.