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ICD-10 Guide
ICD-10 CodesS12.030

S12.030

Billable

Displaced posterior arch fracture of first cervical vertebra

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

Code Description

ICD-10 S12.030 is a billable code used to indicate a diagnosis of displaced posterior arch fracture of first cervical vertebra.

Key Diagnostic Point:

A displaced posterior arch fracture of the first cervical vertebra, also known as the atlas, is a significant injury that can result from high-energy trauma, such as motor vehicle accidents, falls from heights, or sports injuries. The atlas supports the skull and allows for nodding and rotation of the head. A fracture in this area can compromise the stability of the cervical spine and potentially lead to spinal cord injury. Clinically, patients may present with neck pain, limited range of motion, and neurological deficits depending on the severity of the fracture and any associated injuries. Diagnosis typically involves imaging studies, including X-rays and CT scans, to assess the fracture's displacement and any potential involvement of the spinal canal. Management may include conservative treatment with immobilization or surgical intervention to stabilize the fracture and prevent further complications. Complications can include chronic pain, neurological impairment, and instability of the cervical spine if not properly managed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for precise documentation of fracture type and displacement
  • Differentiation from other cervical spine injuries
  • Potential for associated neurological injuries
  • Variability in treatment approaches based on fracture severity

Audit Risk Factors

  • Inadequate documentation of fracture characteristics
  • Failure to document associated neurological deficits
  • Misclassification of fracture type
  • Inconsistent coding of treatment modalities

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation must include mechanism of injury, neurological assessment, and imaging results.

Common Clinical Scenarios

Trauma patients presenting with neck pain after a fall or collision.

Billing Considerations

Ensure thorough documentation of any immediate interventions and patient stability.

Surgery

Documentation Requirements

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

Common Clinical Scenarios

Patients requiring surgical stabilization due to significant displacement or instability.

Billing Considerations

Document any pre-existing conditions that may affect surgical outcomes.

Coding Guidelines

Inclusion Criteria

Use S12.030 When
  • Follow ICD
  • CM guidelines for coding injuries, ensuring specificity in fracture type and location
  • Document the mechanism of injury and any associated conditions

Exclusion Criteria

Do NOT use S12.030 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Arthrodesis, anterior or posterior technique, cervical

Clinical Scenario

Used in cases requiring stabilization of the cervical spine post-fracture.

Documentation Requirements

Operative report detailing the procedure and indications for surgery.

Specialty Considerations

Ensure alignment with the diagnosis of a displaced fracture.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

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

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding 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 a displaced fracture of the first cervical vertebra?

A displaced fracture of the first cervical vertebra can lead to instability and potential spinal cord injury, making prompt diagnosis and management critical.