Rib Injury ICD-10-CM Codes

Learn the ICD-10-CM codes for rib injury. This thorough resource includes information on billable codes, clinical explanations, synonyms, and more.

By Ericka Pingol on Aug 8, 2025.

Fact Checked by Gale Alagos.

Use Code

What ICD-10 codes are used for rib injury?

Rib injuriess encompass various types of injuries affecting the ribs, such as fractures or dislocations. Accurate ICD-10-CM codes are crucial for medical billing and documentation. Below are the commonly used ICD-10 codes for rib injuries:

S22.0: Fracture of rib(s), sternum, and thoracic spine: This code is used for rib, sternum, and thoracic spine fractures.
S22.3: Fracture of one rib: This code is used when a single rib is fractured due to trauma or injury.
S22.4: Fracture of multiple ribs: This code is used when two or more ribs are fractured, often from blunt chest trauma.
S22.5: Flail chest: This code is used when a segment of the rib cage breaks and becomes detached, typically involving multiple consecutive rib fractures.
S20.219: Contusion of unspecified front wall of thorax: This code is used for bruising to the anterior chest wall when the exact rib is not specified.
S20.211: Contusion of right front wall of thorax: This code is used for bruising of the right anterior chest wall, often due to blunt trauma over the ribs.
S20.212: Contusion of left front wall of thorax
This code is used for bruising of the left anterior chest wall, indicating soft tissue injury overlying the ribs.
S29.012: Strain of muscle and tendon of back wall of thorax
This code is used for muscular strain near the posterior ribs, commonly from overuse or trauma.

Which rib injury ICD codes are billable?

Rib fractures are billable under S22.3 (one rib), S22.4 (multiple ribs), and S22.5 (flail chest) when the code includes a 7th character for the encounter: A (initial), D (subsequent), or S (sequela). For example, S22.4XXA is billable for multiple rib fractures during the initial visit.

Contusions over the rib area are also billable when laterality and encounter type are specified. Use S20.211A for right-sided thoracic contusion, S20.212A for left, and S20.219A for unspecified side—all valid for initial encounters.

For muscle strains near the ribs, S29.012A is billable for initial encounters affecting the back wall of the thorax, with D or S used for follow-ups or complications.

To ensure billability, use the full code with placeholders and the correct 7th character.

Clinical information

Rib injuries often result from direct trauma to the chest and may range from a simple closed fracture to more complex multiple fractures involving the bony thorax.
The most common presentation is localised chest pain that worsens with deep breathing, coughing, or movement. In more severe cases, especially with multiple fractures of ribs, patients may experience difficulty breathing or signs of respiratory distress.
Fratures can involve different structures within the thoracic region. A thoracic vertebra fracture, particularly of the thoracic neural arch, thoracic spinous process, or thoracic transverse process, may occur alongside rib fractures, especially in high-impact trauma or falls.
In cases of trauma with back involvement, clinicians should also assess for possible thoracic intervertebral disc injury or spinal cord injury, which may complicate the clinical picture and affect treatment decisions.
Each case is coded and managed differently depending on the type and severity of the injury. For example, an initial encounter for closed fracture refers to a first-time evaluation and treatment for a fracture where the bone does not break the skin, while an initial encounter for open fracture indicates a more severe injury with broken skin and potential for infection.
Delayed healing may also occur, especially in older adults or those with comorbidities, requiring longer recovery and follow-up.
When managing thoracic trauma, clinicians must consider the possibility of coexisting injuries, such as lung contusions, hemothorax, or pneumothorax, especially when multiple rib fractures are present.
Comprehensive imaging is often required to evaluate the full extent of injury to the spine and ribs. Rehabilitation focuses on pain control, respiratory support, and gradual mobility to avoid complications like pneumonia or chronic pain.

Synonyms Include

Rib fracture
Broken rib
Rib dislocation
Flail chest
Traumatic pneumothorax
Thoracic vertebra fracture
Thoracic neural arch fracture

Commonly asked questions

The ICD-10-CM codes for rib injury depend on the type and extent of trauma. For rib fractures, use S22.3XXA for a fracture of one rib and S22.4XXA for multiple rib fractures during the initial encounter. These codes require a 7th character to indicate the encounter type (e.g., A for initial, D for subsequent).

The appropriate ICD-10-CM code for rib pain is R07.89 – Other chest pain. While not rib-specific, this code is often used for general chest wall or rib pain when no underlying fracture or injury is confirmed.

The ICD-10-CM code for a sprain or strain of the rib region is S29.012A – Strain of muscle and tendon of back wall of thorax, initial encounter. Additional characters are used to reflect subsequent encounters or sequelae.

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