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ICD-10 Guide
ICD-10 CodesS12.39

S12.39

Billable

Other fracture of fourth cervical vertebra

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

Code Description

ICD-10 S12.39 is a billable code used to indicate a diagnosis of other fracture of fourth cervical vertebra.

Key Diagnostic Point:

The S12.39 code refers to fractures of the fourth cervical vertebra (C4) that do not fall into the more specific categories of fractures. These injuries can occur due to various mechanisms, including high-impact trauma such as motor vehicle accidents, falls from heights, or sports injuries. The cervical spine is particularly vulnerable to injury due to its mobility and the weight of the head it supports. Fractures at this level can lead to significant neurological deficits, depending on the severity and type of fracture. Clinical evaluation typically involves a thorough history and physical examination, followed by imaging studies such as X-rays, CT scans, or MRIs to assess the fracture's nature and any associated spinal cord injury. Management may range from conservative treatment, including immobilization and pain management, to surgical intervention for stabilization and decompression of the spinal cord. Complications can include chronic pain, neurological deficits, and instability of the cervical spine, necessitating careful monitoring and follow-up.

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 additional codes
  • Differentiation from other cervical vertebra fractures

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to capture associated neurological deficits
  • Misclassification of fracture type
  • Lack of follow-up documentation on treatment outcomes

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 patients presenting after falls, motor vehicle accidents, or sports injuries.

Billing Considerations

Ensure that all relevant details regarding the injury and initial management are documented to support the coding.

Surgery

Documentation Requirements

Detailed operative reports that describe the surgical procedure, indications for surgery, and any complications encountered.

Common Clinical Scenarios

Patients requiring surgical stabilization of the cervical spine due to fracture.

Billing Considerations

Accurate coding of surgical procedures performed in conjunction with the fracture management is essential.

Coding Guidelines

Inclusion Criteria

Use S12.39 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 involvement

Exclusion Criteria

Do NOT use S12.39 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

63015CPT Code

Laminectomy, cervical, single segment

Clinical Scenario

Performed to relieve pressure on the spinal cord due to a C4 fracture.

Documentation Requirements

Operative report detailing the procedure and indications.

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 accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cervical fractures, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 significance of coding S12.39 accurately?

Accurate coding of S12.39 is crucial for proper reimbursement, tracking of injury patterns, and ensuring appropriate patient management. It also helps in identifying trends in cervical spine injuries for research and prevention efforts.