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ICD-10 Guide
ICD-10 CodesS12.000

S12.000

Billable

Unspecified displaced fracture of first cervical vertebra

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 S12.000 is a billable code used to indicate a diagnosis of unspecified displaced fracture of first cervical vertebra.

Key Diagnostic Point:

The S12.000 code refers to an unspecified displaced fracture of the first cervical vertebra, commonly known as the atlas. This type of fracture can occur due to high-impact trauma, such as motor vehicle accidents, falls from heights, or sports injuries. The atlas supports the skull and allows for the nodding motion of the head. Displacement of this vertebra can lead to significant complications, including spinal cord injury, neurological deficits, and instability of the cervical spine. Clinical evaluation typically involves a thorough history and physical examination, followed by imaging studies such as X-rays, CT scans, or MRIs to confirm the fracture and assess for any associated injuries. Management may include immobilization, surgical intervention, or a combination of both, depending on the severity and displacement of the fracture. Early recognition and appropriate treatment are crucial to prevent long-term complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of fractures
  • Need for precise imaging interpretation
  • Potential for associated neurological injuries
  • Documentation of mechanism of injury

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of fracture (displaced vs. non-displaced)
  • Lack of imaging reports in the medical record
  • Inconsistent clinical findings with coded diagnosis

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation must include a detailed account of the mechanism of injury, initial assessment findings, and imaging results.

Common Clinical Scenarios

Patients presenting after trauma with neck pain, neurological symptoms, or altered consciousness.

Billing Considerations

Rapid assessment and stabilization are critical; ensure all findings are documented to support coding.

Surgery

Documentation Requirements

Operative reports must detail the surgical approach, findings, and any fixation methods used.

Common Clinical Scenarios

Surgical intervention for unstable fractures or those with neurological compromise.

Billing Considerations

Ensure that the operative report correlates with the diagnosis and that all procedures are documented.

Coding Guidelines

Inclusion Criteria

Use S12.000 When
  • Follow ICD
  • CM guidelines for coding fractures, ensuring that the type of fracture (displaced) is accurately documented
  • Use additional codes for any associated injuries or complications

Exclusion Criteria

Do NOT use S12.000 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Anterior cervical discectomy and fusion

Clinical Scenario

Used in cases where surgical intervention is necessary for a displaced fracture.

Documentation Requirements

Operative report must detail the procedure and rationale for surgery.

Specialty Considerations

Ensure that the surgical approach aligns with the diagnosis and that all findings are documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of cervical spine injuries, improving the accuracy of diagnoses and treatment plans.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cervical spine injuries, improving the accuracy of diagnoses and treatment plans.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of cervical spine injuries, improving the accuracy of diagnoses and treatment plans.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding S12.000 accurately?

Accurate coding of S12.000 is crucial for appropriate reimbursement, tracking of injury patterns, and ensuring that patients receive the correct treatment based on their specific injuries.