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ICD-10 Guide
ICD-10 CodesS12.19

S12.19

Billable

Other fracture of second cervical vertebra

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

Code Description

ICD-10 S12.19 is a billable code used to indicate a diagnosis of other fracture of second cervical vertebra.

Key Diagnostic Point:

The S12.19 code refers to fractures of the second cervical vertebra (C2), which can occur due to various mechanisms of injury, including trauma from falls, motor vehicle accidents, or sports injuries. The C2 vertebra, also known as the axis, plays a crucial role in the rotation of the head and supports the skull. Fractures in this area can lead to significant neurological deficits, including paralysis or loss of sensation, depending on the severity and type of fracture. Common types of fractures include odontoid fractures, hangman's fractures, and burst fractures. Diagnosis typically involves imaging studies such as X-rays, CT scans, or MRIs to assess the fracture's nature and any associated spinal cord injury. Management may include conservative treatment with immobilization or surgical intervention, such as decompression or stabilization, depending on the fracture's complexity and the patient's overall condition. Complications can include chronic pain, instability, and neurological impairment, making timely and accurate diagnosis and treatment essential.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and associated injuries
  • Need for precise documentation of mechanism of injury
  • Potential for neurological involvement requiring detailed assessment
  • Differentiation from other cervical spine injuries

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of fracture
  • Misclassification of fracture severity
  • Lack of clarity on neurological assessment

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Complete documentation of the patient's condition upon arrival, including mechanism of injury, neurological status, and initial imaging results.

Common Clinical Scenarios

Trauma cases involving falls, sports injuries, or vehicular accidents leading to suspected cervical spine injuries.

Billing Considerations

Ensure thorough documentation of any neurological deficits and imaging findings to support coding.

Surgery

Documentation Requirements

Detailed operative reports outlining the surgical approach, findings, and any complications encountered during the procedure.

Common Clinical Scenarios

Surgical interventions for stabilization or decompression of the spinal cord following a fracture.

Billing Considerations

Accurate coding requires clear documentation of the surgical procedure and any related postoperative care.

Coding Guidelines

Inclusion Criteria

Use S12.19 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code reflects the specific type of fracture and any associated conditions
  • Document the mechanism of injury and any neurological assessments thoroughly

Exclusion Criteria

Do NOT use S12.19 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

63015CPT Code

Laminectomy, cervical, for decompression of spinal cord

Clinical Scenario

Used in cases where surgical intervention is required for spinal cord decompression due to a C2 fracture.

Documentation Requirements

Operative report detailing the procedure, indications, and findings.

Specialty Considerations

Ensure that the surgical approach aligns with the diagnosis and that all relevant details 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 accuracy of data collection and reimbursement processes. S12.19 provides a distinct code for other fractures of the second cervical vertebra, enhancing clarity in clinical documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cervical spine injuries, improving the accuracy of data collection and reimbursement processes. S12.19 provides a distinct code for other fractures of the second cervical vertebra, enhancing clarity in clinical documentation.

Reimbursement & Billing Impact

reimbursement processes. S12.19 provides a distinct code for other fractures of the second cervical vertebra, enhancing clarity in clinical documentation.

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 are the common causes of fractures of the second cervical vertebra?

Common causes include high-energy trauma such as motor vehicle accidents, falls from heights, and sports injuries. Low-energy falls can also result in fractures, especially in older adults with osteoporosis.