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ICD-10 Guide
ICD-10 CodesS12.301

S12.301

Billable

Unspecified nondisplaced fracture of fourth cervical vertebra

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

Code Description

ICD-10 S12.301 is a billable code used to indicate a diagnosis of unspecified nondisplaced fracture of fourth cervical vertebra.

Key Diagnostic Point:

The S12.301 code refers to an unspecified nondisplaced fracture of the fourth cervical vertebra (C4). 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 often 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 spinal cord involvement. Diagnosis is usually confirmed through imaging studies such as X-rays, CT scans, or MRIs, which help visualize the fracture and assess any potential complications. Management may include conservative treatment with immobilization, pain management, and physical therapy, or surgical intervention if there is a risk of spinal cord injury or instability. Complications can include chronic pain, neurological deficits, or the development of post-traumatic arthritis. Accurate coding is essential for proper treatment reimbursement and tracking of injury patterns.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of fracture types
  • Need for precise imaging interpretation
  • Potential for associated neurological injuries
  • Differentiation from other cervical spine injuries

Audit Risk Factors

  • Inadequate documentation of fracture type
  • Failure to specify laterality or associated injuries
  • Misinterpretation of imaging results
  • Inconsistent treatment documentation

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation must include mechanism of injury, initial assessment findings, and 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 and that any neurological assessments are clearly noted.

Surgery

Documentation Requirements

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

Common Clinical Scenarios

Surgical intervention for stabilization of the cervical spine following a nondisplaced fracture.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use S12.301 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code accurately reflects the clinical documentation and that all relevant details about the fracture are included

Exclusion Criteria

Do NOT use S12.301 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Anterior cervical discectomy and fusion

Clinical Scenario

Used when surgical intervention is required for stabilization of the cervical spine.

Documentation Requirements

Operative report detailing the procedure and indications for surgery.

Specialty Considerations

Ensure that the surgical necessity is well-documented to support the procedure.

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 data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cervical spine injuries, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 has cracked but remains aligned, while a displaced fracture involves a misalignment of the bone fragments.