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ICD-10 Guide
ICD-10 CodesS12.001

S12.001

Billable

Unspecified nondisplaced fracture of first cervical vertebra

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

Code Description

ICD-10 S12.001 is a billable code used to indicate a diagnosis of unspecified nondisplaced fracture of first cervical vertebra.

Key Diagnostic Point:

The S12.001 code refers to an unspecified nondisplaced fracture of the first cervical vertebra, also known as the atlas. This type of fracture typically occurs due to trauma, such as falls, motor vehicle accidents, or sports injuries. The atlas supports the skull and allows for the nodding motion of the head. A nondisplaced fracture means that the bone has cracked but has not moved out of alignment, which can often lead to less severe symptoms compared to displaced fractures. Patients may present with neck pain, limited range of motion, and neurological symptoms if there is any associated spinal cord involvement. Diagnosis is usually confirmed through imaging studies such as X-rays, CT scans, or MRIs, which help visualize the fracture and assess for any potential complications. Management often involves immobilization with a cervical collar and close monitoring, with surgical intervention considered in cases of instability or neurological compromise.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for precise imaging interpretation
  • Potential for associated injuries in the cervical spine
  • Documentation of mechanism of injury

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of fracture
  • Misinterpretation of imaging results
  • Lack of follow-up documentation on treatment outcomes

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

Billing Considerations

Emergency physicians must ensure that all relevant details are documented to support the diagnosis and any potential interventions.

Surgery

Documentation Requirements

Operative reports must detail the surgical approach, findings, and any fixation methods used.

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 complications encountered during the procedure.

Coding Guidelines

Inclusion Criteria

Use S12.001 When
  • Follow the ICD
  • CM coding guidelines for injuries, ensuring that the code accurately reflects the clinical scenario and that all documentation supports the diagnosis

Exclusion Criteria

Do NOT use S12.001 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

63015CPT Code

Laminectomy, cervical, anterior approach

Clinical Scenario

Used in cases where surgical intervention is necessary due to instability or neurological compromise.

Documentation Requirements

Operative report must detail the procedure and findings.

Specialty Considerations

Neurosurgeons should document the rationale for surgery and any complications.

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 accuracy of diagnoses and treatment tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cervical spine injuries, improving the accuracy of diagnoses and treatment tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of cervical spine injuries, improving the accuracy of diagnoses and treatment tracking.

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 means that the bone has broken and moved out of alignment, while a nondisplaced fracture indicates that the bone has cracked but remains in its normal position.