Health Information Management

Tip: Using ICD-10-CM Excludes notes for thorax fractures

APCs Insider, November 14, 2014

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Fracture codes for the thorax are located in category S22 (fracture of rib[s], sternum, and thoracic spine). Category S22 contains an Excludes1 and Excludes2 note underneath the heading. The Excludes1 note is for transection of thorax (S28.1). In ICD-10-CM, the Excludes1 note indicates mutually exclusive diagnoses that should never be reported together.
The Excludes2 note is for:
  • Fracture of clavicle (S42.0-)
  • Fracture of scapula (S42.1-)
In ICD-10-CM, the Excludes2 note is used for diagnoses that may occur at the same time, but are not included in subsequent codes in that category. Excludes2 diagnoses can be reported along with the diagnoses from that category with proper documentation.
This tip is adapted from “ICD-10-CM anatomy refresher: Thoracic cage” in the November issue of Briefings on APCs.

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