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ICD-10 Guide
ICD-10 CodesS12.290

S12.290

Billable

Other displaced fracture of third cervical vertebra

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

Code Description

ICD-10 S12.290 is a billable code used to indicate a diagnosis of other displaced fracture of third cervical vertebra.

Key Diagnostic Point:

The S12.290 code refers to a specific type of injury characterized by a displaced fracture of the third cervical vertebra (C3). This injury typically occurs due to high-energy trauma, such as motor vehicle accidents, falls from significant heights, or sports-related injuries. The displacement of the fracture can lead to instability in the cervical spine, potentially compromising the spinal cord and resulting in neurological deficits. Clinical presentation may include neck pain, limited range of motion, and neurological symptoms such as weakness or numbness in the upper extremities. Diagnosis is confirmed through imaging studies, including X-rays, CT scans, or MRI, which help assess the extent of the fracture and any associated spinal cord injury. Management often involves stabilization of the cervical spine, which may include surgical intervention, such as decompression and fusion, depending on the severity of the fracture and the presence of neurological compromise. Rehabilitation is crucial for recovery, focusing on restoring mobility and strength.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of cervical fractures
  • Understanding the implications of displacement
  • Identifying associated neurological injuries
  • Navigating surgical versus non-surgical management

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of fracture (displaced vs. non-displaced)
  • Misclassification of the fracture severity
  • Lack of clarity on associated neurological deficits

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation must include a detailed account of the mechanism of injury, initial assessment findings, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with acute neck pain following trauma, often requiring imaging and stabilization.

Billing Considerations

Emergency departments must ensure thorough documentation to support the diagnosis and any subsequent procedures.

Surgery

Documentation Requirements

Operative reports must detail the surgical approach, techniques used, and any intraoperative findings related to the fracture.

Common Clinical Scenarios

Surgical management of cervical fractures, including decompression and fusion procedures.

Billing Considerations

Surgeons should document the rationale for surgical intervention and any complications encountered.

Coding Guidelines

Inclusion Criteria

Use S12.290 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code reflects the specific type of fracture and its displacement
  • Document the mechanism of injury and any associated conditions to support the coding choice

Exclusion Criteria

Do NOT use S12.290 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

63015CPT Code

Laminectomy, cervical, single segment

Clinical Scenario

Performed for decompression of the spinal cord due to a displaced fracture.

Documentation Requirements

Operative report must detail the procedure performed and the rationale for surgical intervention.

Specialty Considerations

Neurosurgeons and orthopedic surgeons should ensure accurate coding based on the surgical approach.

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. S12.290 provides a clear distinction for displaced fractures, which is crucial for appropriate management and reimbursement.

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. S12.290 provides a clear distinction for displaced fractures, which is crucial for appropriate management and reimbursement.

Reimbursement & Billing Impact

reimbursement.

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 S12.290 accurately?

Accurate coding of S12.290 is essential for proper treatment planning, reimbursement, and tracking of injury outcomes. It ensures that healthcare providers can deliver appropriate care based on the specific nature of the fracture.