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ICD-10 Guide
ICD-10 CodesS12.291

S12.291

Billable

Other nondisplaced fracture of third cervical vertebra

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

Code Description

ICD-10 S12.291 is a billable code used to indicate a diagnosis of other nondisplaced fracture of third cervical vertebra.

Key Diagnostic Point:

The S12.291 code refers to a nondisplaced fracture of the third cervical vertebra (C3), which is a common injury resulting from trauma, such as falls, motor vehicle accidents, or sports injuries. Nondisplaced fractures occur when the bone cracks but maintains its proper alignment, which can lead to less severe symptoms compared to displaced fractures. Clinical presentation may include neck pain, limited range of motion, and neurological symptoms if the spinal cord is affected. Diagnosis typically involves imaging studies such as X-rays, CT scans, or MRI to confirm the fracture and assess any potential complications. Management often includes conservative treatment with immobilization, pain management, and physical therapy, although surgical intervention may be necessary in cases of instability or neurological compromise. Complications can include chronic pain, stiffness, or, in severe cases, spinal cord injury. Accurate coding requires thorough documentation of the mechanism of injury, clinical findings, and treatment provided.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between displaced and nondisplaced fractures
  • Understanding the specific anatomical location of the fracture
  • Documenting the mechanism of injury accurately
  • Identifying associated neurological symptoms

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 follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Acute care documentation must include the mechanism of injury, initial assessment findings, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with neck pain after a fall or motor vehicle accident, requiring imaging to rule out fractures.

Billing Considerations

Ensure that all relevant imaging results and neurological assessments are documented to support the diagnosis.

Surgery

Documentation Requirements

Operative reports should detail the surgical approach, findings, and any fixation devices used if surgery is performed.

Common Clinical Scenarios

Surgical management of unstable cervical fractures or decompression for neurological symptoms.

Billing Considerations

Document the rationale for surgical intervention and any postoperative complications.

Coding Guidelines

Inclusion Criteria

Use S12.291 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code reflects the specific type of fracture and its anatomical location
  • Document the mechanism of injury and any associated conditions

Exclusion Criteria

Do NOT use S12.291 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

63015CPT Code

Laminectomy, cervical, for decompression of spinal cord

Clinical Scenario

Used when surgical intervention is required for decompression due to fracture.

Documentation Requirements

Operative report must detail the procedure performed and rationale.

Specialty Considerations

Ensure that the surgical approach and any complications 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 fractures, improving the granularity of data for treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cervical fractures, improving the granularity of data for treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of cervical fractures, improving the granularity of data for treatment outcomes and resource allocation.

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 involves a break in the bone where the ends are not aligned, while a nondisplaced fracture means the bone cracks but remains in its normal position.