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ICD-10 Guide
ICD-10 CodesS12.201

S12.201

Billable

Unspecified nondisplaced fracture of third cervical vertebra

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

Code Description

ICD-10 S12.201 is a billable code used to indicate a diagnosis of unspecified nondisplaced fracture of third cervical vertebra.

Key Diagnostic Point:

The S12.201 code refers to an unspecified nondisplaced fracture of the third cervical vertebra (C3). This type of injury typically occurs due to trauma, such as falls, motor vehicle accidents, or sports injuries. A nondisplaced fracture means that the bone has cracked but remains in its normal alignment, which can lead to less severe symptoms compared to displaced fractures. Patients may present with neck pain, limited range of motion, and neurological symptoms depending on the extent of the injury. Diagnostic imaging, such as X-rays or MRI, is essential to confirm the diagnosis and rule out associated injuries. Management often involves conservative treatment, including immobilization with a cervical collar, pain management, and physical therapy. In some cases, surgical intervention may be necessary if there are complications or if conservative measures fail. Understanding the mechanisms of injury and the clinical implications of a nondisplaced fracture is crucial for accurate coding and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for precise documentation of injury mechanism
  • Differentiation from other cervical spine injuries
  • Potential for associated neurological deficits

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of fracture
  • Misclassification of fracture type (nondisplaced vs. displaced)
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with neck pain after a fall or motor vehicle accident.

Billing Considerations

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

Surgery

Documentation Requirements

Operative reports should detail the surgical approach, findings, and any interventions performed.

Common Clinical Scenarios

Surgical management of cervical fractures due to instability or neurological compromise.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use S12.201 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code reflects the specific type of fracture and its clinical implications
  • Document the mechanism of injury and any associated conditions

Exclusion Criteria

Do NOT use S12.201 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 required for stabilization.

Documentation Requirements

Operative report detailing the procedure and indications for surgery.

Specialty Considerations

Ensure that the surgical necessity is well-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 granularity of data for treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cervical spine injuries, improving the granularity of data for treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of cervical spine injuries, improving the granularity of data for treatment outcomes and resource allocation.

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 difference between a nondisplaced and displaced fracture?

A nondisplaced fracture means the bone is cracked but remains aligned, while a displaced fracture involves a misalignment of the bone fragments.