S22.072B: Unstable burst fracture of T9-T10 vertebra, initial encounter for open fracture
S22.072B, unstable burst fracture of T9-T10 vertebra, initial encounter for open fracture, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 17 HCPCS Level II codes, including G0130 (Single energy x-ray absorptiometry (sexa) bone density…), 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 S22.072B as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0130 | Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) | Special coverage instructions apply | — | 2 |
| 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 |
| G2010 | Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment | Carrier judgment | — | 1 |
| G2250 | Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment | Carrier judgment | — | 1 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G2251 | Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of clinical discussion | Carrier judgment | — | 1 |
| G0151 | Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 1 |
Medicare policy articles listing S22.072B
- A59040: Billing and Coding: Bone Mass Measurement (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36460, L39268
- A57132: Billing and Coding: Bone Mass Measurement (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36460, L39268
- A54767: Billing and Coding: Medicare Preventive Coverage for Certain Vaccines (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes)
- A57311: Billing and Coding: Physical Therapy - Home Health (CGS Administrators, LLC (HHH MAC); 7 Level II codes). LCD with the same title: L33942
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 S22 diagnoses (Fracture of rib(s), sternum and thoracic spine)
- S22.072A — Unstable burst fracture of T9-T10 vertebra, initial encounter for…
- S22.070A — Wedge compression fracture of T9-T10 vertebra, initial encounter for…
- S22.070B — Wedge compression fracture of T9-T10 vertebra, initial encounter for…
- S22.071A — Stable burst fracture of T9-T10 vertebra, initial encounter for…
- S22.071B — Stable burst fracture of T9-T10 vertebra, initial encounter for open…
- S22.078A — Other fracture of T9-T10 vertebra, initial encounter for closed…
- S22.078B — Other fracture of T9-T10 vertebra, initial encounter for open fracture
- S22.079A — Unspecified fracture of T9-T10 vertebra, initial encounter for…
- S22.079B — Unspecified fracture of T9-T10 vertebra, initial encounter for open…
- S22.001B — Stable burst fracture of unspecified thoracic vertebra, initial…
- S22.002B — Unstable burst fracture of unspecified thoracic vertebra, initial…
- S22.009A — Unspecified fracture of unspecified thoracic vertebra, initial…
- S22.009B — Unspecified fracture of unspecified thoracic vertebra, initial…
- S22.010A — Wedge compression fracture of first thoracic vertebra, initial…
- S22.010B — Wedge compression fracture of first thoracic vertebra, initial…
- S22.011A — Stable burst fracture of first thoracic vertebra, initial encounter…
- S22.011B — Stable burst fracture of first thoracic vertebra, initial encounter…
- S22.018A — Other fracture of first thoracic vertebra, initial encounter for…
- S22.018B — Other fracture of first thoracic vertebra, initial encounter for…
- S22.019A — Unspecified fracture of first thoracic vertebra, initial encounter…
- S22.019B — Unspecified fracture of first thoracic vertebra, initial encounter…
- S22.020A — Wedge compression fracture of second thoracic vertebra, initial…
- S22.020B — Wedge compression fracture of second thoracic vertebra, initial…
- S22.021A — Stable burst fracture of second thoracic vertebra, initial encounter…
- S22.021B — Stable burst fracture of second thoracic vertebra, initial encounter…
- S22.022A — Unstable burst fracture of second thoracic vertebra, initial…
- S22.022B — Unstable burst fracture of second thoracic vertebra, initial…
- S22.028A — Other fracture of second thoracic vertebra, initial encounter for…
- S22.028B — Other fracture of second thoracic vertebra, initial encounter for…
- S22.029A — Unspecified fracture of second thoracic vertebra, initial encounter…
Frequently asked questions
Does Medicare cover S22.072B (Unstable burst fracture of T9-T10 vertebra, initial…)?
Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list S22.072B as a covered diagnosis for 17 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 S22.072B?
The Level II codes from the policies most specific to this diagnosis are G0130 (Single energy x-ray absorptiometry (sexa) bone density…, 2 articles); 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 S22.072B?
A59040 (Billing and Coding: Bone Mass Measurement); A57132 (Billing and Coding: Bone Mass Measurement); A54767 (Billing and Coding: Medicare Preventive Coverage for Certain Vaccines), and 1 more article.
What is ICD-10-CM code S22.072B?
S22.072B is the ICD-10-CM code for unstable burst fracture of T9-T10 vertebra, initial encounter for open fracture, in category S22 (Fracture of rib(s), sternum and thoracic spine), chapter 19: Injury, poisoning and other consequences of external causes.
Next steps
- Run a reimbursement report for a device billed under G0130
- Watch G0130 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0130
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