S22.41XG
Multiple fractures of ribs, right side, subsequent encounter for fracture with delayed healing
S22.41XG (also written S2241XG) is a billable ICD-10-CM diagnosis code for multiple fractures of ribs, right side, subsequent encounter for fracture with delayed healing. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 354 codes in category S22 (Fracture of rib(s), sternum and thoracic spine). Its 7th character, G, means subsequent encounter for fracture with delayed healing. Its coding notes include a Code first instruction, a Use additional code instruction, a Code also instruction, 2 Excludes1 entries and 15 Excludes2 entries.
7th character
Category S22 requires a 7th character. S22.41 has only 5 characters, so a placeholder X fills the 6th position.
Guidelines tips
From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.
A fracture not stated as open or closed is coded closed, and one not stated as displaced or not displaced is coded displaced. Nonunion and malunion have their own 7th characters.
The 7th character depends on whether the patient is in active treatment, not on who sees the patient. An aftercare Z code is not used for injury aftercare.
Each injury gets its own code unless a combination code exists, with the most serious injury first. Superficial injuries at the same site as a more severe injury are not coded. Injuries during medical care are coded as complications.
Code first
If the underlying condition listed here is present and known, sequence it first.
Use additional code
Add the listed code as a secondary code, if known.
Also from chapter/block level (1 note)
- code to identify any retained foreign body, if applicable (Z18.-)
Code also
Two codes may be needed to describe the condition. This note gives no sequencing order.
Excludes1
Not coded here. The listed conditions generally should not be reported together.
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
Also from chapter/block level (13 notes)
- burns and corrosions (T20-T32)
- effects of foreign body in bronchus (T17.5)
- effects of foreign body in esophagus (T18.1)
- effects of foreign body in lung (T17.8)
- effects of foreign body in trachea (T17.4)
- frostbite (T33-T34)
- injuries of axilla
- injuries of clavicle
- injuries of scapular region
- injuries of shoulder
- insect bite or sting, venomous (T63.4)
- birth trauma (P10-P15)
- obstetric trauma (O70-O71)
Care settings
How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.
Home Health Primary
Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the Musculoskeletal Rehabilitation clinical group.
Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026IRF 60% Rule · with another code
Counts toward the IRF 60 percent rule only in combination, not on its own. Fracture combination: at least one lower-extremity fracture together with an upper-extremity or rib/sternum fracture, or fractures in both lower extremities.
Source: CMS IRF Presumptive Compliance-3, FY 2027 IRF PPS final rule files, effective for discharges on or after October 1, 2026Includes
Further defines or gives examples of the content of the category.
- fracture of thoracic neural arch
- fracture of thoracic spinous process
- fracture of thoracic transverse process
- fracture of thoracic vertebra
- fracture of thoracic vertebral arch
Also from chapter/block level (3 notes)
- injuries of breast
- injuries of chest (wall)
- injuries of interscapular area
Notes
- A fracture not indicated as displaced or nondisplaced should be coded to displaced
- A fracture not indicated as open or closed should be coded to closed
Also from chapter/block level (2 notes)
- Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
- The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.