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ICD-10 Guide
ICD-10 CodesS12.300

S12.300

Billable

Unspecified displaced fracture of fourth cervical vertebra

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

Code Description

ICD-10 S12.300 is a billable code used to indicate a diagnosis of unspecified displaced fracture of fourth cervical vertebra.

Key Diagnostic Point:

The S12.300 code refers to an unspecified displaced fracture of the fourth cervical vertebra (C4). This type of injury typically occurs due to trauma, such as motor vehicle accidents, falls, or sports injuries. Displaced fractures indicate that the bone fragments have moved out of their normal alignment, which can lead to potential complications such as spinal cord injury, nerve damage, and instability of the cervical spine. Clinical evaluation often includes a thorough history and physical examination, followed by imaging studies such as X-rays, CT scans, or MRIs to assess the fracture's extent and any associated injuries. Management may involve conservative treatment with immobilization or surgical intervention, depending on the fracture's severity and the patient's overall condition. Complications can include chronic pain, neurological deficits, and the need for further surgical procedures. Accurate coding is essential for proper reimbursement and tracking of patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture descriptions and types
  • Need for precise documentation of displacement
  • Potential for associated injuries requiring additional codes
  • Differentiation from similar cervical spine codes

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to capture associated injuries
  • Misclassification of fracture type
  • Inconsistent use of external cause codes

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 motor vehicle accident.

Billing Considerations

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

Surgery

Documentation Requirements

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

Common Clinical Scenarios

Patients undergoing cervical fusion or stabilization procedures following a C4 fracture.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use S12.300 When
  • Follow the ICD
  • CM guidelines for coding fractures, ensuring that the specific site and type of fracture are accurately captured
  • Use additional codes for any associated injuries or complications

Exclusion Criteria

Do NOT use S12.300 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 a displaced C4 fracture.

Documentation Requirements

Operative report detailing the procedure, indications, and any complications.

Specialty Considerations

Ensure that the surgical approach and any hardware used 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 fractures, improving the granularity of data collection and reimbursement processes. S12.300 reflects the need for precise documentation to capture the nature of the injury accurately.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the granularity of data collection and reimbursement processes. S12.300 reflects the need for precise documentation to capture the nature of the injury accurately.

Reimbursement & Billing Impact

reimbursement processes. S12.300 reflects the need for precise documentation to capture the nature of the injury accurately.

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 specifying the displacement in a cervical fracture?

Specifying displacement is crucial as it affects the treatment approach and potential complications. Displaced fractures may require surgical intervention to realign the vertebrae and prevent spinal cord injury.