ICD-10 Guide

Odontoid Fracture

ICD-10 Coding for Odontoid Fracture(S12.11xA, S12.12xA)

PRIMARY SPECIALTYOrthopedic Surgery

COMPLEXITYHigh

LAST UPDATED09/15/2025

Sam Tuffun, PT, DPT

Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Odontoid Fracture?

Essential facts and insights about Odontoid Fracture

Key Clinical Considerations:

Neck pain and stiffness
Neurological deficits (e.g., weakness, numbness)
Imaging findings of fracture on X-ray or CT scan

Clinical Information

Clinical Criteria & Documentation Requirements

Patient history including mechanism of injury
Detailed physical examination findings
Imaging reports and interpretations

Coding Guidelines

Usage Guidelines & Examples

Follow guidelines for coding fractures; avoid unspecified codes.
Common errors include misclassifying fracture type.

Code Exclusions

Important Exclusions

Cervical spine fractures not involving the odontoid
Other specific cervical spine injuries

Specialty Focus

Primary Specialty

Orthopedic Surgery

Specialty Applications

Adults and children with cervical spine injuries
Emergency departments and orthopedic clinics

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

Comprehensive clinical documentation
Accurate code selection based on clinical criteria
Proper exclusion considerations
Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

Ensure proper documentation for billing
Verify code specificity requirements
Check for any additional codes needed
Review payer-specific guidelines

Common Issues

Insufficient clinical documentation
Incorrect code selection
Missing supporting diagnoses
Timing and frequency documentation

Frequently Asked Questions

Documentation requirements?

Include detailed history, physical exam, and imaging results.

Billing considerations?

Ensure accurate coding to reflect the severity and treatment provided.

Odontoid Fracture

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

Documentation requirements?

Billing considerations?

Odontoid Fracture

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

Documentation requirements?

Billing considerations?