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ICD-10 Guide
ICD-10 CodesS12.500

S12.500

Billable

Unspecified displaced fracture of sixth cervical vertebra

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

Code Description

ICD-10 S12.500 is a billable code used to indicate a diagnosis of unspecified displaced fracture of sixth cervical vertebra.

Key Diagnostic Point:

The S12.500 code refers to an unspecified displaced fracture of the sixth cervical vertebra (C6), which is a critical area of the spine that can significantly impact neurological function and mobility. Displaced fractures occur when the bone fragments are misaligned, potentially compromising the spinal canal and leading to serious complications such as spinal cord injury. Common mechanisms of injury include high-impact trauma from motor vehicle accidents, falls from heights, or sports-related injuries. Clinical presentation may include neck pain, limited range of motion, neurological deficits, or signs of spinal cord involvement. Diagnosis typically involves imaging studies such as X-rays, CT scans, or MRIs to assess the fracture's nature and any associated injuries. Management may range from conservative treatment, including immobilization and physical therapy, to surgical intervention for stabilization and decompression of the spinal cord. The prognosis depends on the severity of the fracture and the timeliness of treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of injury
  • Need for precise documentation of fracture type and displacement
  • Potential for associated neurological injuries
  • Variability in treatment approaches and outcomes

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of fracture or displacement
  • Lack of imaging reports to support the diagnosis
  • Inconsistent coding of associated neurological deficits

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation must include a thorough assessment of the patient's neurological status, mechanism of injury, and imaging results.

Common Clinical Scenarios

Patients presenting with acute neck pain following trauma, requiring immediate imaging and evaluation for potential spinal cord injury.

Billing Considerations

Ensure that all relevant details regarding the injury mechanism and neurological examination findings are documented to support coding.

Surgery

Documentation Requirements

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

Common Clinical Scenarios

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

Billing Considerations

Accurate coding requires clear documentation of the surgical procedure and any complications encountered.

Coding Guidelines

Inclusion Criteria

Use S12.500 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code reflects the specific nature of the fracture and any associated injuries
  • Documentation must support the diagnosis and treatment plan

Exclusion Criteria

Do NOT use S12.500 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 fracture.

Documentation Requirements

Operative report must detail the procedure performed 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 cervical spine injuries, improving the granularity of data for clinical and billing purposes. S12.500 provides a clear designation for unspecified fractures, but coders must ensure accurate documentation to avoid audit risks.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cervical spine injuries, improving the granularity of data for clinical and billing purposes. S12.500 provides a clear designation for unspecified fractures, but coders must ensure accurate documentation to avoid audit risks.

Reimbursement & Billing Impact

billing purposes. S12.500 provides a clear designation for unspecified fractures, but coders must ensure accurate documentation to avoid audit risks.

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, as it impacts treatment decisions, prognosis, and reimbursement. Unspecified codes may lead to audit risks and potential denials.