ICD-10 Codes for Thoracic and Lumbar Burst Fractures

Note: The codes below are ICD-10-CM (current U.S. standard). ICD-9-CM was retired in 2015. Burst fractures are a specific type of vertebral fracture involving comminution with retropulsion of fragments into the spinal canal.

Thoracic Spine Burst Fractures

• S22.000A–S22.099A: Fracture of thoracic vertebra, initial encounter
• S22.000B–S22.099B: Subsequent encounter for fracture with routine healing
• S22.000D–S22.099D: Subsequent encounter with delayed healing
• S22.000G–S22.099G: Subsequent encounter with nonunion
• S22.000K–S22.099K: Subsequent encounter with malunion
• S22.000S–S22.099S: Sequela

Specific codes depend on level (T1–T12), laterality, and encounter type. The 7th character denotes encounter status (A=initial, D=routine healing, G=delayed, K=nonunion, S=sequela).

Lumbar Spine Burst Fractures

• S32.000A–S32.099A: Fracture of lumbar vertebra, initial encounter
• Same 7th character extensions apply.

Key Coding Principles

• Burst fracture = vertebral fracture with spinal cord/cauda equina injury risk. Document neurologic status.
• If spinal cord injury present: Add S24.1- / S34.1- (injury of spinal cord at thoracic/lumbar level).
• Multiple levels: Code each level separately.
• Pathologic fracture (tumor, osteoporosis): Use M48.5- or M80.- with site specificity.

Clinical Context

• Burst fractures: High-energy trauma (MVC, fall from height).
• Denis 3-column model: Anterior + middle + posterior column involvement.
• Neurologic deficit in ~50% (thoracic), ~20% (lumbar).
• Treatment: TLSO bracing (stable, no neuro deficit) vs. surgical decompression/fusion (unstable, neuro deficit).

Accurate coding requires specifying level, encounter, and associated spinal cord injury. Always verify with current ICD-10-CM manual or encoder.