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ICD-10 Guide
ICD-10 CodesS12.391

S12.391

Billable

Other nondisplaced fracture of fourth cervical vertebra

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

Code Description

ICD-10 S12.391 is a billable code used to indicate a diagnosis of other nondisplaced fracture of fourth cervical vertebra.

Key Diagnostic Point:

The S12.391 code refers to a nondisplaced fracture of the fourth cervical vertebra (C4), which is a common injury resulting from trauma, such as falls, motor vehicle accidents, or sports injuries. Nondisplaced fractures occur when the bone cracks but maintains its proper alignment. The cervical vertebrae are critical for supporting the skull, protecting the spinal cord, and facilitating neck movement. Symptoms may include neck pain, stiffness, and potential neurological deficits depending on the severity of the injury. Diagnosis typically involves imaging studies such as X-rays, CT scans, or MRIs to confirm the fracture and assess for any associated injuries. Management may include conservative treatment with immobilization, pain management, and physical therapy, or surgical intervention in more severe cases. Complications can include chronic pain, reduced mobility, or neurological impairment if the spinal cord is affected. Accurate coding is essential for proper treatment and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between displaced and nondisplaced fractures
  • Understanding the specific cervical vertebra involved
  • Documenting associated neurological symptoms
  • Identifying the mechanism of injury

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of fracture (nondisplaced vs. displaced)
  • Lack of supporting imaging documentation
  • Misclassification of the cervical vertebra involved

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Complete documentation of the patient's history, mechanism of injury, and initial assessment findings.

Common Clinical Scenarios

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

Billing Considerations

Ensure that all imaging results are documented and correlate with the clinical findings.

Surgery

Documentation Requirements

Detailed operative notes, including indications for surgery and postoperative care.

Common Clinical Scenarios

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

Billing Considerations

Document the surgical approach and any complications encountered during the procedure.

Coding Guidelines

Inclusion Criteria

Use S12.391 When
  • Follow the ICD
  • CM coding guidelines for injuries, ensuring accurate documentation of the fracture type and associated conditions
  • Use external cause codes to specify the mechanism of injury

Exclusion Criteria

Do NOT use S12.391 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.

Specialty Considerations

Ensure that the surgical approach is documented, especially in cases of complex injuries.

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 displaced and nondisplaced fracture?

A displaced fracture occurs when the bone fragments are separated and misaligned, while a nondisplaced fracture maintains the bone's normal alignment despite the fracture.