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ICD-10 Guide
ICD-10 CodesS12.2

S12.2

Billable

Fracture of third cervical vertebra

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

Code Description

ICD-10 S12.2 is a billable code used to indicate a diagnosis of fracture of third cervical vertebra.

Key Diagnostic Point:

The S12.2 code refers to a fracture of the third cervical vertebra (C3), which is a critical component of the cervical spine. This type of fracture can occur due to various mechanisms of injury, including trauma from motor vehicle accidents, falls, sports injuries, or violent acts. The C3 vertebra is located in the neck and plays a vital role in supporting the skull and protecting the spinal cord. Fractures at this level can lead to significant neurological deficits, including quadriplegia, depending on the severity and type of fracture. Clinical evaluation typically involves a thorough history and physical examination, followed by imaging studies such as X-rays, CT scans, or MRIs to assess the extent of the injury. Management may include conservative treatment with immobilization or surgical intervention, such as decompression and stabilization, depending on the fracture's characteristics and associated neurological compromise. Complications can include chronic pain, instability, and potential for further neurological injury if not managed appropriately.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types (e.g., compression, burst, or fracture-dislocation)
  • Potential for associated neurological injuries
  • Need for precise documentation of mechanism of injury
  • Variations in treatment approaches (surgical vs. conservative)

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document neurological assessments
  • Misclassification of fracture type
  • Inconsistent coding of associated injuries

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with neck pain after trauma, altered mental status, or neurological deficits.

Billing Considerations

Ensure that all relevant imaging studies and neurological evaluations are documented to support the diagnosis.

Surgery

Documentation Requirements

Operative reports must detail the surgical approach, findings, and any complications encountered during the procedure.

Common Clinical Scenarios

Surgical intervention for unstable fractures or those with neurological compromise.

Billing Considerations

Document the rationale for surgical intervention and any pre-existing conditions that may affect recovery.

Coding Guidelines

Inclusion Criteria

Use S12.2 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code accurately reflects the specific type of fracture and any associated injuries
  • Document the mechanism of injury and any neurological assessments performed

Exclusion Criteria

Do NOT use S12.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Anterior cervical discectomy and fusion

Clinical Scenario

Used in cases of C3 fracture with spinal cord compression requiring surgical intervention.

Documentation Requirements

Operative report detailing the procedure, indications, and any intraoperative findings.

Specialty Considerations

Ensure that the surgical approach and any complications 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 fractures, improving the granularity of data for treatment and outcomes. S12.2 provides a clear designation for C3 fractures, facilitating better tracking of patient care and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cervical spine fractures, improving the granularity of data for treatment and outcomes. S12.2 provides a clear designation for C3 fractures, facilitating better tracking of patient care and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of cervical spine fractures, improving the granularity of data for treatment and outcomes. S12.2 provides a clear designation for C3 fractures, facilitating better tracking of patient care and outcomes.

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 are the common causes of a C3 vertebra fracture?

Common causes include motor vehicle accidents, falls, sports injuries, and violence. The mechanism of injury often involves significant force applied to the neck.

How is a C3 fracture diagnosed?

Diagnosis typically involves a physical examination, assessment of neurological function, and imaging studies such as X-rays or CT scans to visualize the fracture.

What are the potential complications of a C3 fracture?

Complications can include neurological deficits, chronic pain, instability of the cervical spine, and the need for surgical intervention.