S20.304A: Unspecified superficial injuries of middle front wall of thorax, initial encounter
S20.304A, unspecified superficial injuries of middle front wall of thorax, initial encounter, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 15 HCPCS Level II codes, including J1670 (Injection, tetanus immune globulin, human, up to 250 units), G0008 (Administration of influenza virus vaccine), G0009 (Administration of pneumococcal vaccine). The articles come from 2 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with S20.304A as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J1670 | Injection, tetanus immune globulin, human, up to 250 units | Special coverage instructions apply | — | 1 |
| G0008 | Administration of influenza virus vaccine | Carrier judgment | — | 1 |
| G0009 | Administration of pneumococcal vaccine | Carrier judgment | — | 1 |
| G0010 | Administration of hepatitis b vaccine | Carrier judgment | — | 1 |
| Q2038 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) | Special coverage instructions apply | — | 1 |
| Q2035 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) | Special coverage instructions apply | — | 1 |
| Q2037 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) | Special coverage instructions apply | — | 1 |
| Q2034 | Influenza virus vaccine, split virus, for intramuscular use (agriflu) | Special coverage instructions apply | — | 1 |
| Q2036 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) | Special coverage instructions apply | — | 1 |
| Q2039 | Influenza virus vaccine, not otherwise specified | Special coverage instructions apply | — | 1 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0158 | Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0160 | Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G2169 | Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
Medicare policy articles listing S20.304A
- A52438: Billing and Coding: Tetanus Immunization (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes)
- A54767: Billing and Coding: Medicare Preventive Coverage for Certain Vaccines (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes)
- A53057: Billing and Coding: Home Health Occupational Therapy (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34560
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other S20 diagnoses (Superficial injury of thorax)
- S20.303A — Unspecified superficial injuries of bilateral front wall of thorax…
- S20.313A — Abrasion of bilateral front wall of thorax, initial encounter
- S20.314A — Abrasion of middle front wall of thorax, initial encounter
- S20.343A — External constriction of bilateral front wall of thorax, initial…
- S20.344A — External constriction of middle front wall of thorax, initial…
- S20.353A — Superficial foreign body of bilateral front wall of thorax, initial…
- S20.354A — Superficial foreign body of middle front wall of thorax, initial…
- S20.373A — Other superficial bite of bilateral front wall of thorax, initial…
- S20.374A — Other superficial bite of middle front wall of thorax, initial…
- S20.213A — Contusion of bilateral front wall of thorax, initial encounter
- S20.214A — Contusion of middle front wall of thorax, initial encounter
- S20.223A — Contusion of bilateral back wall of thorax, initial encounter
- S20.224A — Contusion of middle back wall of thorax, initial encounter
Frequently asked questions
Does Medicare cover S20.304A (Unspecified superficial injuries of middle front wall of…)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list S20.304A as a covered diagnosis for 15 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 S20.304A?
The Level II codes from the policies most specific to this diagnosis are J1670 (Injection, tetanus immune globulin, human, up to 250 units, 1 article); G0008 (Administration of influenza virus vaccine, 1 article); G0009 (Administration of pneumococcal vaccine, 1 article); G0010 (Administration of hepatitis b vaccine, 1 article); Q2038 (Influenza virus vaccine, split virus, when administered to…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list S20.304A?
A52438 (Billing and Coding: Tetanus Immunization); A54767 (Billing and Coding: Medicare Preventive Coverage for Certain Vaccines); A53057 (Billing and Coding: Home Health Occupational Therapy).
What is ICD-10-CM code S20.304A?
S20.304A is the ICD-10-CM code for unspecified superficial injuries of middle front wall of thorax, initial encounter, in category S20 (Superficial injury of thorax), chapter 19: Injury, poisoning and other consequences of external causes.
Next steps
- Run a reimbursement report for a device billed under J1670
- Watch J1670 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1670
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 19: Injury, poisoning and other consequences of external causes · All diagnoses · HCPCS lookup