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FY2027 ICD-10-CM reference

S22.050A: Wedge compression fracture of T5-T6 vertebra, initial encounter for closed fracture

By the HCC Buddy Coding Team

The official ICD-10-CM descriptor is Wedge compression fracture of T5-T6 vertebra, initial encounter for closed fracture. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.

Billable code. Verified against the official FY2027 order file.

CMS-HCC V28

  • HCC 401: Vertebral Fractures without Spinal Cord Injury · RAF 0.522, Community Non-Dual Aged (CNA)

Payment year 2027, 2026 dates of service. HCC from the CMS 2027 Initial ICD-10-CM Mappings; RAF from the CMS-HCC V28 relative factors. For 2027 dates of service, CMS has not yet published the payment year 2028 mappings.

CMS-HCC V24

Not used for payment year 2027 Medicare Advantage payment

ESRD

  • HCC 169: Vertebral Fractures without Spinal Cord Injury

Coefficient pending: payment year 2027 coefficients for this model are not yet verified, so no RAF is shown. Mapping: PY2026 CMS mapping; CMS 2027 initial file unchanged.

PACE

Source verification pending

RxHCC

No category in the PY2026 CMS mapping; CMS 2027 initial file unchanged

HHS-HCC

  • HCC 228: Vertebral Fractures without Spinal Cord Injury

RAF not applicable: HHS-HCC weights vary by metal level. Mapping: HHS-HCC 2026 benefit year.

FY2027 Tabular instructions

Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.

Instructional note

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

Source: S00-T88 (chapter, inherited).

Instructional note

code to identify any retained foreign body, if applicable (Z18.-)

Source: S00-T88 (chapter, inherited).

Excludes2

birth trauma (P10-P15)

Source: S00-T88 (chapter, inherited).

Excludes2

obstetric trauma (O70-O71)

Source: S00-T88 (chapter, inherited).

Instructional note

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.

Source: S00-T88 (chapter, inherited).

Includes

injuries of breast

Source: S20-S29 (section, inherited).

Includes

injuries of chest (wall)

Source: S20-S29 (section, inherited).

Includes

injuries of interscapular area

Source: S20-S29 (section, inherited).

Excludes2

burns and corrosions (T20-T32)

Source: S20-S29 (section, inherited).

Excludes2

effects of foreign body in bronchus (T17.5)

Source: S20-S29 (section, inherited).

Excludes2

effects of foreign body in esophagus (T18.1)

Source: S20-S29 (section, inherited).

Excludes2

effects of foreign body in lung (T17.8)

Source: S20-S29 (section, inherited).

Excludes2

effects of foreign body in trachea (T17.4)

Source: S20-S29 (section, inherited).

Excludes2

frostbite (T33-T34)

Source: S20-S29 (section, inherited).

Excludes2

injuries of axilla

Source: S20-S29 (section, inherited).

Excludes2

injuries of clavicle

Source: S20-S29 (section, inherited).

Excludes2

injuries of scapular region

Source: S20-S29 (section, inherited).

Excludes2

injuries of shoulder

Source: S20-S29 (section, inherited).

Excludes2

insect bite or sting, venomous (T63.4)

Source: S20-S29 (section, inherited).

Instructional note

A fracture not indicated as displaced or nondisplaced should be coded to displaced

Source: S22 (category, inherited).

Instructional note

A fracture not indicated as open or closed should be coded to closed

Source: S22 (category, inherited).

Includes

fracture of thoracic neural arch

Source: S22 (category, inherited).

Includes

fracture of thoracic spinous process

Source: S22 (category, inherited).

Includes

fracture of thoracic transverse process

Source: S22 (category, inherited).

Includes

fracture of thoracic vertebra

Source: S22 (category, inherited).

Includes

fracture of thoracic vertebral arch

Source: S22 (category, inherited).

Code first

, if applicable, spinal cord injury (S24.0-, S24.1-)

Source: S22 (category, inherited).

Code also

, if applicable, any associated condition such as:

Source: S22 (category, inherited).

Code also

injury of intrathoracic organ (S27.-)

Source: S22 (category, inherited).

Code also

traumatic hemopneumothorax (S27.2)

Source: S22 (category, inherited).

Code also

traumatic hemothorax (S27.1-)

Source: S22 (category, inherited).

Code also

traumatic pneumothorax (S27.0)

Source: S22 (category, inherited).

Excludes1

transection of thorax (S28.1)

Source: S22 (category, inherited).

Excludes2

fracture of clavicle (S42.0-)

Source: S22 (category, inherited).

Excludes2

fracture of scapula (S42.1-)

Source: S22 (category, inherited).

Seventh-character instruction

The appropriate 7th character is to be added to each code from category S22

Source: S22 (category, inherited).

Instructional note

initial encounter for closed fracture

Source: S22 (category, inherited).

Instructional note

initial encounter for open fracture

Source: S22 (category, inherited).

Instructional note

subsequent encounter for fracture with routine healing

Source: S22 (category, inherited).

Instructional note

subsequent encounter for fracture with delayed healing

Source: S22 (category, inherited).

Instructional note

subsequent encounter for fracture with nonunion

Source: S22 (category, inherited).

Instructional note

sequela

Source: S22 (category, inherited).

Seventh-character definitions

  • A: initial encounter for closed fracture
  • B: initial encounter for open fracture
  • D: subsequent encounter for fracture with routine healing
  • G: subsequent encounter for fracture with delayed healing
  • K: subsequent encounter for fracture with nonunion
  • S: sequela

Source: CMS FY2027 Tabular List and Alphabetic Index.

Open Tabular instructions and code details

Compare the FY2027 additions, removals and billable-status changes

What does S22.050A mean in FY2027?

The official ICD-10-CM descriptor is Wedge compression fracture of T5-T6 vertebra, initial encounter for closed fracture. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.

Is S22.050A billable in FY2027?

The FY2027 order file marks S22.050A as billable. Check the complete Tabular instructions and documentation before assigning it.

Does S22.050A map to an HCC?

In the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service), S22.050A maps to CMS-HCC V28 HCC 401 (Vertebral Fractures without Spinal Cord Injury). For 2027 dates of service, CMS has not yet published the payment year 2028 mappings. Under the PY2026 CMS mapping; CMS 2027 initial file unchanged: ESRD HCC 169; no RxHCC category. Coefficients for these models are pending verification for payment year 2027. HHS-HCC: HCC 228 under the HHS-HCC 2026 benefit year mapping (no RAF; HHS-HCC weights vary by metal level). CMS-HCC V24: not used for payment year 2027 Medicare Advantage payment (CMS CY 2027 Rate Announcement). The PACE mapping is still pending verification for FY2027.

Source: CMS FY2027 ICD-10-CM order file. Payment model: CMS CY 2027 Rate Announcement. Read the FY2027 Official Guidelines.

Review the FY2026 April edition