ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesS12.40

S12.40

Billable

Unspecified fracture of fifth cervical vertebra

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

Code Description

ICD-10 S12.40 is a billable code used to indicate a diagnosis of unspecified fracture of fifth cervical vertebra.

Key Diagnostic Point:

The S12.40 code refers to an unspecified fracture of the fifth cervical vertebra (C5), which is a critical component of the cervical spine. Fractures in this region can result from various mechanisms of injury, including trauma from motor vehicle accidents, falls, sports injuries, or violent acts. The cervical vertebrae are essential for supporting the head and protecting the spinal cord, and injuries here can lead to significant neurological deficits, including paralysis or loss of sensation. Clinical evaluation typically involves a thorough history and physical examination, followed by imaging studies such as X-rays, CT scans, or MRIs to confirm the fracture and assess for any associated spinal cord injury. Management may range from conservative treatment, including immobilization and pain management, to surgical intervention, depending on the fracture's stability and the presence of neurological compromise. Complications can include chronic pain, instability, and neurological deficits, making accurate diagnosis and management crucial.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of fracture
  • Lack of imaging reports in the medical record
  • Inconsistent clinical findings related to neurological status

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

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

Billing Considerations

Emergency providers must ensure that all relevant imaging and neurological assessments are documented to support the diagnosis.

Surgery

Documentation Requirements

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

Common Clinical Scenarios

Surgical intervention for unstable fractures or those with significant neurological compromise.

Billing Considerations

Surgeons should ensure that the type of fracture and any associated injuries are clearly documented to support coding.

Coding Guidelines

Inclusion Criteria

Use S12.40 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the fracture type is unspecified
  • Documentation must support the diagnosis, including the mechanism of injury and any imaging results

Exclusion Criteria

Do NOT use S12.40 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 cervical spine fractures.

Documentation Requirements

Operative report must detail the procedure performed and the indication for surgery.

Specialty Considerations

Orthopedic and neurosurgical specialties must 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 fractures, improving the granularity of data collection and enhancing the ability to track outcomes and complications associated with cervical spine injuries.

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 enhancing the ability to track outcomes and complications associated with cervical spine injuries.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, improving the granularity of data collection and enhancing the ability to track outcomes and complications associated with cervical spine injuries.

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 type of fracture?

Specifying the type of fracture is crucial for accurate coding, treatment planning, and understanding the potential complications associated with the injury.