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ICD-10 Guide
ICD-10 CodesS12.400

S12.400

Billable

Unspecified displaced fracture of fifth cervical vertebra

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

Code Description

ICD-10 S12.400 is a billable code used to indicate a diagnosis of unspecified displaced fracture of fifth cervical vertebra.

Key Diagnostic Point:

The S12.400 code refers to an unspecified displaced fracture of the fifth cervical vertebra (C5). This type of injury typically occurs due to trauma, such as motor vehicle accidents, falls, or sports injuries. Displaced fractures indicate that the bone fragments have moved out of their normal alignment, which can lead to potential complications such as spinal cord injury, nerve damage, and instability of the cervical spine. Clinical evaluation often includes a thorough history and physical examination, followed by imaging studies such as X-rays, CT scans, or MRIs to assess the fracture's extent and any associated injuries. Management may involve conservative treatment, such as immobilization with a cervical collar, or surgical intervention to stabilize the spine and decompress any affected neural structures. The prognosis depends on the severity of the fracture and the presence of any neurological deficits.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture classification and description
  • Need for precise documentation of displacement and associated injuries
  • Potential for multiple coding options based on clinical findings
  • Differentiation from similar cervical spine codes

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of fracture (displaced vs. non-displaced)
  • Lack of imaging reports to support the diagnosis
  • Incorrect linkage of diagnosis to treatment procedures

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation must include a detailed account of the mechanism of injury, initial assessment findings, and imaging results.

Common Clinical Scenarios

Patients presenting with neck pain after a fall or motor vehicle accident, requiring immediate imaging and assessment.

Billing Considerations

Timely documentation is critical for trauma cases; ensure all findings are recorded promptly.

Surgery

Documentation Requirements

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

Common Clinical Scenarios

Surgical intervention for stabilization of a displaced C5 fracture with or without decompression.

Billing Considerations

Ensure that the surgical procedure is clearly linked to the diagnosis for accurate billing.

Coding Guidelines

Inclusion Criteria

Use S12.400 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code reflects the specific nature of the fracture and any associated injuries
  • Document the mechanism of injury and any neurological assessments

Exclusion Criteria

Do NOT use S12.400 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Anterior cervical discectomy and fusion

Clinical Scenario

Used in cases where surgical intervention is required for a displaced C5 fracture.

Documentation Requirements

Operative report detailing the procedure, indications, and findings.

Specialty Considerations

Ensure that the procedure is linked to the diagnosis of the fracture.

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 granularity of data for treatment and outcomes. S12.400 provides a clear designation for displaced fractures, aiding in clinical decision-making and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cervical spine injuries, improving the granularity of data for treatment and outcomes. S12.400 provides a clear designation for displaced fractures, aiding in clinical decision-making and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of cervical spine injuries, improving the granularity of data for treatment and outcomes. S12.400 provides a clear designation for displaced fractures, aiding in clinical decision-making 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 significance of specifying 'displaced' in the fracture code?

Specifying 'displaced' indicates that the fracture has resulted in misalignment of the vertebra, which can lead to more severe complications, including potential spinal cord injury. Accurate coding is essential for appropriate treatment planning and resource allocation.