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ICD-10 Guide
ICD-10 CodesChapter 19: Injury, poisoning and other consequences of external causesS13

S13

Non-billable

Dislocation and sprain of joints and ligaments at neck level

Chapter 19:Injury, poisoning and other consequences of external causes

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 S13 is a used to indicate a diagnosis of dislocation and sprain of joints and ligaments at neck level.

Key Diagnostic Point:

The ICD-10 Level 1 Category code S13 encompasses dislocations and sprains of joints and ligaments at the neck level, primarily affecting the cervical spine. This category includes various conditions such as cervical sprains, strains, and dislocations that may result from trauma, falls, or sports injuries. Clinically, these conditions can lead to significant pain, restricted movement, and potential long-term complications if not properly diagnosed and treated. The accurate coding of these conditions is crucial for effective treatment planning and management, as well as for tracking patient outcomes and healthcare utilization.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of conditions covered
  • Potential for misdiagnosis
  • Need for precise documentation

Audit Risk Factors

  • Inadequate documentation
  • Misclassification of injury severity
  • Failure to specify laterality

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Physical Medicine and Rehabilitation

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical and administrative impact of the S13 code category is significant, as it directly influences patient management strategies and healthcare resource allocation. Accurate coding can enhance quality measures by ensuring that patients receive appropriate follow-up care and rehabilitation services. Additionally, understanding the trends related to neck injuries can inform public health initiatives aimed at reducing the incidence of such injuries, ultimately improving population health outcomes.

ICD-9 vs ICD-10

The clinical and administrative impact of the S13 code category is significant, as it directly influences patient management strategies and healthcare resource allocation. Accurate coding can enhance quality measures by ensuring that patients receive appropriate follow-up care and rehabilitation services. Additionally, understanding the trends related to neck injuries can inform public health initiatives aimed at reducing the incidence of such injuries, ultimately improving population health outcomes.

Reimbursement & Billing Impact

Reimbursement considerations often depend on the documentation of the injury's severity and the medical necessity of the services rendered. It is important to ensure that all relevant details are captured in the medical record to support the billed services, including any imaging studies or consultations that may be necessary for comprehensive care.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for S13

Coding & Billing References

  • •
    Official ICD-10 Guidelines for S13

Frequently Asked Questions

What conditions are included in S13?

S13 includes cervical sprains, strains, and dislocations of the cervical vertebrae and associated ligaments. It covers acute injuries as well as chronic conditions resulting from repetitive strain or trauma.

When should I use S13 codes?

S13 codes should be used when documenting injuries related to the neck, particularly following an incident of trauma or when a patient presents with neck pain and dysfunction that is determined to be due to a sprain or dislocation.

What documentation is required for S13?

Documentation should include a detailed account of the patient's history, the mechanism of injury, clinical findings, diagnostic imaging results, and the treatment plan. Clear documentation of the specific type of injury and its severity is essential.