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ICD-10 Guide
ICD-10 CodesS12.691

S12.691

Billable

Other nondisplaced fracture of seventh cervical vertebra

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

Code Description

ICD-10 S12.691 is a billable code used to indicate a diagnosis of other nondisplaced fracture of seventh cervical vertebra.

Key Diagnostic Point:

The S12.691 code refers to a nondisplaced fracture of the seventh cervical vertebra (C7), which is located at the base of the neck and plays a crucial role in supporting the head and facilitating movement. Nondisplaced fractures indicate that the bone has cracked but remains in its normal position, which can often lead to less severe symptoms compared to displaced fractures. Common mechanisms of injury include falls, sports injuries, or motor vehicle accidents. Patients may present with neck pain, limited range of motion, and neurological symptoms if there is spinal cord involvement. Diagnosis typically involves a thorough clinical examination followed by imaging studies such as X-rays, CT scans, or MRIs to confirm the fracture and assess for any associated injuries. Management often includes conservative treatment such as immobilization with a cervical collar, pain management, and physical therapy. In some cases, surgical intervention may be necessary if there is significant instability or neurological compromise. Complications can include chronic pain, stiffness, or, in rare cases, neurological deficits if the spinal cord is affected.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between displaced and nondisplaced fractures
  • Understanding the specific anatomical location of the fracture
  • Identifying associated injuries or complications
  • Navigating documentation requirements for trauma cases

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the nondisplaced nature of the fracture
  • Misclassification of fracture type (displaced vs. nondisplaced)
  • Lack of imaging reports to support the diagnosis

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 with neck pain after a fall or motor vehicle accident.

Billing Considerations

Emergency providers should 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 interventions performed.

Common Clinical Scenarios

Surgical management of unstable fractures or those with neurological compromise.

Billing Considerations

Surgeons should document the rationale for surgical intervention and any postoperative complications.

Coding Guidelines

Inclusion Criteria

Use S12.691 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the fracture type and location are accurately documented
  • Use additional codes for any associated injuries or complications

Exclusion Criteria

Do NOT use S12.691 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 stabilization.

Documentation Requirements

Operative report detailing the procedure and indications.

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 fractures, improving the accuracy of data collection and reimbursement processes. S12.691 provides a clear distinction between nondisplaced and displaced fractures, which is crucial for treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of data collection and reimbursement processes. S12.691 provides a clear distinction between nondisplaced and displaced fractures, which is crucial for treatment planning.

Reimbursement & Billing Impact

reimbursement processes. S12.691 provides a clear distinction between nondisplaced and displaced fractures, which is crucial for treatment planning.

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 not aligned, while a nondisplaced fracture means the bone cracks but remains in its normal position.